Objectives

Using QuantiFERON-TB Gold In-Tube (QFT-GIT) for monitoring tuberculosis (TB) and latent TB infection treatment effect is controversial. The present study aimed to evaluate the dynamic changes of interferon gamma (IFN-γ) levels along with latent TB infection treatment via a randomized controlled study.

Methods

A total of 910 participants treated with 8 weeks of once-weekly rifapentine plus isoniazid (group A), 890 treated with 6 weeks of twice-weekly rifapentine plus isoniazid (group B) and 818 untreated controls (group C) were followed for 2 years to track active TB development. QFT-GIT tests were repeated three times for all groups: before treatment (T0), at completion of treatment (T1) and 3 months after completion of treatment (T2).

Results

Similar rates of persistent QFT-GIT reversion were observed in groups A (19.0%, 173/910), B (18.5%, 165/890) and C (20.7%, 169/818) (p 0.512). The dynamic changes of IFN-γ levels were not statistically significant among the three groups. In treated participants, individuals with higher baseline IFN-γ levels showed increased TB occurrence (1.0%, 9/896) compared to those with lower baseline levels (0.2%, 2/904) (p 0.037). A similar but statistically insignificant trend was also observed in untreated controls (1.8% (7/400) vs. 0.5% (2/418), p 0.100). When TB cases were matched with non-TB cases on baseline IFN-γ levels, no significant differences were found with respect to the dynamic changes in IFN-γ levels with time, regardless of whether they received treatment.

Conclusions

QFT-GIT reversion or decreased IFN-γ levels should not be used for monitoring host response to latent TB infection treatment.

中文翻译：

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干扰素-γ释放测定法的动态变化以及潜伏性结核感染治疗的结果。

目标

使用QuantiFERON-TB金管（QFT-GIT）监测结核病（TB）和潜在的TB感染治疗效果存在争议。本研究旨在通过随机对照研究评估γ干扰素（IFN-γ）水平与潜伏性结核感染治疗的动态变化。

方法

共有910名参与者接受了为期2年的每周2次利福喷汀加异烟肼治疗（每周一次）（A组），890名患者接受了每周两次利福喷汀加异烟肼6周治疗（每周一次）（B组）和818名未经治疗的对照组（C组）进行了2年的随访跟踪活跃的结核病发展情况。所有组均重复三次QFT-GIT测试：治疗前（T0），治疗完成（T1）和治疗结束后3个月（T2）。

结果

在A组（19.0％，173/910），B（18.5％，165/890）和C（20.7％，169/818）组中观察到相似的持续QFT-GIT逆转率（p 0.512）。三组间IFN-γ水平的动态变化无统计学意义。在接受治疗的参与者中，与较低的基线水平（0.2％，2/904）相比，较高的基线IFN-γ水平的人表现出更高的结核病发生率（1.0％，9/896）（p = 0.037）。在未经处理的对照组中也观察到了类似但无统计学意义的趋势（1.8％（7/400）对0.5％（2/418），p 0.100）。当结核病例与非结核病例在基线IFN-γ水平上相匹配时，无论他们是否接受治疗，IFN-γ水平随时间的动态变化均无显着差异。

结论

QFT-GIT逆转或IFN-γ水平降低不应用于监测宿主对潜伏性结核感染治疗的反应。