Acceptance of interferon-gamma release assay by a high-risk urban cohort

Int J Tuberc Lung Dis. 2011 Oct;15(10):1334-9. doi: 10.5588/ijtld.11.0029.

Abstract

Background: QuantiFERON ® -TB Gold (QFT-G), an interferon-gamma release assay, is approved for the diagnosis of latent tuberculosis infection (LTBI). It is unknown if patients at high risk for LTBI will more readily accept LTBI treatment based on tuberculosis skin testing (TST) or QFT-G.

Methods: Prospectively enrolled participants were interviewed, were read an informational paragraph on QFT-G, completed a questionnaire and were tested with QFT-G.

Results: A total of 230 consecutive participants with a history of hepatitis C virus infection and active or past illicit drug use were enrolled and underwent QFT-G testing: 77% had recent TST, 82% were human immuno- deficiency virus co-infected, 87% had a history of injection drug use, and 52% a history of homelessness. Of the 230 participants, 148 (64%) stated a preference for TST compared to QFT-G. The majority would take treatment based on either test (68%). A minority of patients (20%) stated a willingness to take LTBI treatment based on TST alone. Black race was associated with a willingness to take treatment based on TST (OR 2.72, 95%CI 1.05-7.10).

Conclusions: Patients at high risk for LTBI were found to prefer TST to QFT-G. Most would accept treatment based on either test, and a subset stated unwillingness to take treatment based on QFT-G results. Outreach and education should accompany QFT-G roll-out in high-risk urban populations.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Biomarkers / analysis
  • Black or African American
  • Boston / epidemiology
  • Female
  • Health Knowledge, Attitudes, Practice* / ethnology
  • Humans
  • Immunoassay*
  • Interferon-gamma / analysis*
  • Latent Tuberculosis / diagnosis*
  • Latent Tuberculosis / drug therapy
  • Latent Tuberculosis / ethnology
  • Latent Tuberculosis / immunology
  • Latent Tuberculosis / microbiology
  • Male
  • Medication Adherence
  • Middle Aged
  • Odds Ratio
  • Patient Acceptance of Health Care* / ethnology
  • Patient Education as Topic*
  • Patient Preference
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Tuberculin Test
  • Urban Population*

Substances

  • Antitubercular Agents
  • Biomarkers
  • Interferon-gamma