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A Summary of Meeting Proceedings on Addressing Variability around the Cut Point in Serial Interferon-γ Release Assay Testing

  • Charles L. Daley (a1) (a2), Randall R. Reves (a2) (a3), Melodie A. Beard (a4), Jeffrey Boyle (a5), Richard B. Clark (a6), James L. Beebe (a7), Antonino Catanzaro (a8), Lisa Chen (a9), Edward Desmond (a10), Susan E. Dorman (a11), T. Warner Hudson (a12), Alfred A. Lardizabal (a13), Hema Kapoor (a14), David C. Marder (a15), Cyndee Miranda (a16), Masahiro Narita (a17), Lee Reichman (a18), Dale Schwab (a19), Barbara J. Seaworth (a20), Paul Terpeluk (a21), Wendy Thanassi (a22) and L. Masae Kawamura (a23)...


On June 13, 2012, a group of key stakeholders, leaders, and national experts on tuberculosis (TB), occupational health, and laboratory science met in Atlanta, Georgia, to focus national discussion on the higher than expected positive results occurring among low-risk, unexposed healthcare workers undergoing serial testing with interferon-γ release assays (IGRAs). The objectives of the meeting were to present the latest clinical and operational research findings on the topic, to discuss evaluation and treatment algorithms that are emerging in the absence of national guidance, and to develop a consensus on the action steps needed to assist programs and physicians in the interpretation of serial testing IGRA results. This report summarizes its proceedings.


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National Jewish Health, 1400 Jackson Street, Denver, CO 80206 (


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1.Centers for Disease Control and Prevention. Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection—United States, 2010. MMWR Recomm Rep 2010;59(RR-5):125.
2.Medical Center Occupational Health Section and Occupational and Environmental Lung Disorders Committee. Protecting health care workers from tuberculosis. J Occup Environ Med 2008;50:852855.
3.Joshi, R, Reingold, AL, Menzies, D, Pai, M. Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. PLoS Med 2006;3:e494.
4.Zwerling, A, van den Hof, S, Scholten, J, Cobelens, F, Menzies, D, Pai, M. Interferon-gamma release assays for tuberculosis screening of healthcare workers: a systematic review. Thorax 2012;67:6270.
5.van Zyl-Smit, RN, Zwerling, A, Dheda, K, Pai, M. Within-subject variability of interferon-g assay results for tuberculosis and boosting effect of tuberculin skin testing: a systematic review. PLoS ONE 2009;4(12):e8517.
6.Ringshausen, F, Schablon, A, Nienhaus, A. Interferon-gamma release assays for the tuberculosis serial testing of healthcare workers: a systematic review. J Occup Med Toxic 2012;7:6.
7.Sahni, R, Miranda, C, Yen-Lieberman, B, et al.Does the implementation of an interferon-γ release assay in lieu of a tuberculin skin test increase acceptance of preventive therapy for latent tuberculosis among healthcare workers? Infect Control Hosp Epidemiol 2009;30:197199.
8.Fong, K, Tomford, JW, Teixeira, L, et al.Challenges of interferon-γ release assay conversions in serial testing of health-care workers in a TB control program. Chest 2012;142:5562.
9.Talati, NJ, Seybold, U, Humphrey, B, et al.Poor concordance between interferon-γ release assays and tuberculin skin tests in diagnosis of latent tuberculosis infection among HIV-infected individuals. BMC Infect Dis 2009;9:15.
10.Gray, J, Belknap, R, Reves, R, et al.Identification of false-positive QuantiFERON-TB Gold In-Tube assays by repeat testing in HIV-infected patients at low risk for tuberculosis. Clin Infect Dis 2012;54(3):e20e23.
11.Kraemer, HC. Evaluating Medical Tests: Objective and Quantitative Guidelines. Newbury Park, CA: Sage, 1992.
12.Veerapathran, A, Joshi, R, Goswami, K, et al.T-cell assays for tuberculosis infection: deriving cut-offs for conversions using reproducibility data. PLoS ONE 2008;3:e1850.
13.van Zyl-Smit, RN, Pai, M, Dheda, K, et al.Within-subject variability and boosting of T-cell interferon-gamma responses after tuberculin skin testing. Am J Respir Crit Care Med 2009;180:4958.
14. QuantiFERON-TB Gold [package insert]. Chadstone, Australia: Cellestis, 2011.


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