Preventive tuberculosis treatment effect on QuantiFERON TB-Gold in-tube testing in a high tuberculosis-endemic country: A clinical trial

Int J Infect Dis. 2020 Feb:91:182-187. doi: 10.1016/j.ijid.2019.11.023. Epub 2019 Nov 23.

Abstract

Background: Whether T-cell interferon-γ responses to Mycobacterium tuberculosis-specific antigens can be influenced by tuberculosis preventive treatment in a high-endemic country is uncertain.

Methods: In this prospective, open-label, controlled study, 513 individuals with silicosis were randomly selected for TB preventive treatment with rifapentine and isoniazid or for observation. QuantiFERON-TB Gold in-tube (QFT-GIT) assay was used to measure IFN-γ response to M. tuberculosis antigens at baseline (T0) and at 6 (T1) and 33 (T2) months after completion of therapy.

Results: A total of 220 subjects were included in the final analysis: 105 and 115 in the prevention and observation arms, respectively. The proportions of QFT-GIT reversion from baseline to T1 were similar in the prevention and observation arms (18.4% vs 12.8%, P=0.566). However, reversion from baseline to T2 was more frequent in the prevention arm than in the observation arm, but the difference was not significant (24.2% vs 6.3%, P=0.881). No significant difference was observed in the quantitative responses of QFT-GIT between the two arms during follow-up at T1 (P=0.648) and T2 (P=0.918).

Conclusions: Preventive tuberculosis treatment has no effect on interferon-γ responses measured by serial QFT-GIT assays in a high tuberculosis-endemic country.

Clinical trials registration: http://www.clinicaltrials.gov NCT02430259.

Keywords: QuantiFERON TB-Gold in-tube; Randomized clinical trial; Serial tests; Tuberculosis preventive treatment.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Antigens, Bacterial / analysis
  • Antigens, Bacterial / immunology
  • Antitubercular Agents / therapeutic use*
  • China / epidemiology
  • Diagnostic Tests, Routine
  • Endemic Diseases / prevention & control
  • Endemic Diseases / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Interferon-gamma / blood*
  • Interferon-gamma Release Tests
  • Isoniazid / therapeutic use
  • Male
  • Middle Aged
  • Prospective Studies
  • Rifampin / analogs & derivatives
  • Rifampin / therapeutic use
  • Tuberculin Test
  • Tuberculosis / blood
  • Tuberculosis / epidemiology
  • Tuberculosis / microbiology
  • Tuberculosis / prevention & control*

Substances

  • Antigens, Bacterial
  • Antitubercular Agents
  • Mycobacterium tuberculosis antigens
  • Interferon-gamma
  • Isoniazid
  • Rifampin
  • rifapentine

Associated data

  • ClinicalTrials.gov/NCT02430259