Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-25T05:28:43.863Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  02 January 2015

Charles L. Daley*
Affiliation:
Department of Medicine, National Jewish Health, Denver, Colorado Department of Medicine, University of Colorado Denver, Aurora, Colorado
Randall R. Reves
Affiliation:
Department of Medicine, University of Colorado Denver, Aurora, Colorado Denver Metro Tuberculosis Control Program, Denver Public Health Department, Denver, Colorado
Melodie A. Beard
Affiliation:
Laboratory Corporation of America Holdings, Burlington, North Carolina
Jeffrey Boyle
Affiliation:
Department of Research and Development, Cellestis-QIAGEN, Melbourne, Australia
Richard B. Clark
Affiliation:
Quest Diagnostics Nichols Institute, Chantilly, Virginia
James L. Beebe
Affiliation:
San Luis Obispo County Public Health Laboratory, San Luis Obispo, California
Antonino Catanzaro
Affiliation:
Department of Medicine, University of California, San Diego, California
Lisa Chen
Affiliation:
Curry International Tuberculosis Center, San Francisco, California; and Department of Medicine, University of California, San Francisco, California
Edward Desmond
Affiliation:
Microbial Diseases Laboratory, California Department of Public Health, Richmond, California
Susan E. Dorman
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
T. Warner Hudson
Affiliation:
University of California, Los Angeles, Health System and Campus, Los Angeles, California; and American College of Occupational and Environmental Medicine, Elk Grove Village, Illinois
Alfred A. Lardizabal
Affiliation:
New Jersey Medical School Global Tuberculosis Institute, Newark, New Jersey; and Department of Medicine, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Hema Kapoor
Affiliation:
Quest Diagnostics, Horsham, Pennsylvania
David C. Marder
Affiliation:
University Health Services, University of Illinois at Chicago (UIC), Chicago, Illinois; and Occupational and Environmental Medicine, UIC, Chicago, Illinois
Cyndee Miranda
Affiliation:
Department of Infectious Disease, Cleveland Clinic, Cleveland, Ohio
Masahiro Narita
Affiliation:
Seattle and King County Department of Public Health, Seattle, Washington; and Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington
Lee Reichman
Affiliation:
New Jersey Medical School Global Tuberculosis Institute, Newark, New Jersey
Dale Schwab
Affiliation:
Quest Diagnostics Nichols Institute, San Juan Capistrano, California
Barbara J. Seaworth
Affiliation:
Heardand National Tuberculosis Center, Austin, Texas; and Department of Medicine, University of Texas Health Science Center, Tyler, Texas
Paul Terpeluk
Affiliation:
Employee Health Service, Cleveland Clinic, Cleveland, Ohio
Wendy Thanassi
Affiliation:
Department of Veterans Affairs, Palo Alto, California; and Department of Emergency Medicine, Stanford University, Stanford, California
L. Masae Kawamura
Affiliation:
Department of Research and Development, North America, Cellestis-QIAGEN, Valencia, California
*
National Jewish Health, 1400 Jackson Street, Denver, CO 80206 (daleyc@njhealth.org)

Abstract

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.

Type
Review Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

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.Google Scholar
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.CrossRefGoogle Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.CrossRefGoogle Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
11.Kraemer, HC. Evaluating Medical Tests: Objective and Quantitative Guidelines. Newbury Park, CA: Sage, 1992.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
14. QuantiFERON-TB Gold [package insert]. Chadstone, Australia: Cellestis, 2011. http://www.cellestis.com/IRM/content/pdf/39111_PI_05990301H_AUS_DEC%202011_ttf.pdf.Google Scholar