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LETTER TO THE EDITOR
Year : 2013  |  Volume : 8  |  Issue : 1  |  Page : 64
Diagnostic performance of interferon-Gamma assay for tuberculosis in immunocompromised patients


1 Department of Emergency Medicine, Tainan Municipal Hospital, Liouying, Taiwan
2 Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying; Department of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan
3 Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Taiwan

Date of Web Publication9-Jan-2013

Correspondence Address:
Shih-Yang Su
Department of Emergency Medicine, Tainan Municipal Hospital, Liouying
Taiwan
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DOI: 10.4103/1817-1737.105723

PMID: 23437019

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How to cite this article:
Su SY, Chao CM, Lai CC. Diagnostic performance of interferon-Gamma assay for tuberculosis in immunocompromised patients. Ann Thorac Med 2013;8:64

How to cite this URL:
Su SY, Chao CM, Lai CC. Diagnostic performance of interferon-Gamma assay for tuberculosis in immunocompromised patients. Ann Thorac Med [serial online] 2013 [cited 2020 Aug 8];8:64. Available from: http://www.thoracicmedicine.org/text.asp?2013/8/1/64/105723


Sir,

We read with great interest a recent article by Eldin et al. who investigated the utility of interferon (INF)-γ level and Quantiferon-TB Gold In tube (QFT-GIT) assay for the diagnosis of pleural tuberculosis (TB). [1] They concluded the ex vivo pleural fluid INF-γ levels is an accurate diagnostic tool for pleural TB. [1]

However, the immune status of the patients in this study was not shown, and we wonder whether the immunocompromised condition would affect the performance of these tests or not. In fact, the role of QFT-GIT for pulmonary TB in immunocompromised patients remains questionable. [2],[3] In the study in Korea, Jung et al. enrolled 119 immunocompromised patients, which included 29 patients with diabetes mellitus, 53 with malignancy, 23 with taking immunosuppressive drugs, and 14 with end-stage renal disease, and found sensitivity and specificity (95% CI) were: (59.0% (44.9-72.0)) and (61.3% (54.4-67.6)) of QFT-GIT for diagnosing smear-negative pulmonary TB. [2] As well as in a previous study by Lai et al. in Taiwan, [3] QFT-GIT assay had more indeterminate and false-negative results than another INF-γ release assays (IGRA) - an enzyme-linked immunospot assay (T-SPOT.TB assay), especially in immunocompromised patients.

Therefore, we would like to suggest that the author should mention the underlying condition - immunocompetent or immunocompromised status - in the description of the demographic characteristics to help reader better understand the background.

 
   References Top

1.Eldin EN, Omar A, Khairy M, Mekawy AH, Ghanem MK. Diagnostic value of ex vivo pleural fluid interferon-gamma versus adapted whole-blood quantiferon-TB gold in tube assays in tuberculous pleural effusion. Ann Thorac Med 2012;7:220-5.  Back to cited text no. 1
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2.Jung JY, Lim JE, Lee HJ, Kim YM, Cho SN, Kim SK, et al. Questionable role of interferon-γ assays for smear-negative pulmonary TB in immunocompromised patients. J Infect 2012;64:188-96.  Back to cited text no. 2
[PUBMED]    
3.Lai CC, Tan CK, Lin SH, Liao CH, Huang YT, Hsueh PR. Diagnostic performance of whole-blood interferon-γ assay and enzyme-linked immunospot assay for active tuberculosis. Diagn Microbiol Infect Dis 2011;71:139-43.  Back to cited text no. 3
    



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