A Feasibility Study for Diagnosis of Latent Tuberculosis Infection Using an IGRA Point-of-Care Platform in South Korea

Yonsei Med J. 2019 Apr;60(4):375-380. doi: 10.3349/ymj.2019.60.4.375.

Abstract

Purpose: This study aimed to evaluate ichroma™ IGRA-TB, a novel point-of-care platform for assaying IFN-γ release, and to compare it with QuantiFERON-TB Gold In-Tube (QFT-GIT) for identifying Mycobacterium tuberculosis (M. tb) infection.

Materials and methods: We recruited 60 healthy subjects, and blood samples were obtained in QFT-GIT blood collection tubes. The blood collection tubes were incubated at 37°C, and culture supernatant was harvested after 18-24 hours. IFN-γ responses were assessed by the ichroma™ IGRA-TB cartridge and the QFT-GIT IFN-γ enzyme-linked immunosorbent assay. Three active TB patients were recruited as a positive control for M. tb infection.

Results: The area under the receiver operating characteristic curve of the ichroma™ IGRA-TB test for differentiating between infected and non-infected individuals was 0.9706 (p<0.001). Inconsistent positivity between the two tests was found in three participants who showed weak positive IFN-γ responses (<1.0 IU/mL) with QFT-GIT. However, the two tests had excellent agreement (95.2%, κ=0.91, p<0.001), and a very strong positive correlation was observed between the IFN-γ values of both tests (r=0.91, p<0.001).

Conclusion: The diagnostic accuracy demonstrated in this study indicates that the ichroma™ IGRA-TB test could be used as a rapid diagnostic method for detecting latent TB infection. It may be particularly beneficial in resource-limited places that require cost-effective laboratory diagnostics.

Keywords: IFN-γ; QuantiFERON-TB Gold In-Tube test; latent TB infection; point-of-care platform; tuberculosis; ichroma™ IGRA-TB.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Area Under Curve
  • Case-Control Studies
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Interferon-gamma / analysis
  • Interferon-gamma / blood*
  • Interferon-gamma Release Tests / methods*
  • Latent Tuberculosis / diagnosis*
  • Latent Tuberculosis / ethnology
  • Latent Tuberculosis / immunology
  • Male
  • Mycobacterium tuberculosis / immunology
  • Mycobacterium tuberculosis / isolation & purification*
  • Point-of-Care Systems*
  • ROC Curve
  • Reagent Kits, Diagnostic
  • Republic of Korea / epidemiology
  • Tuberculin Test / methods*
  • Young Adult

Substances

  • Reagent Kits, Diagnostic
  • Interferon-gamma