The number of studies which evaluated interferon-gamma release assays (IGRAs) results after anti-tuberculosis (TB) treatment has been rapidly increasing. The aim of this study was to investigate the potential use of IGRAs (QFT-GIT, T-SPOT.TB, QFT-Plus) in assessing the response to anti-TB treatment. We searched all studies in English language published from 1 October 2011 to 18 November 2018 in PubMed, Web of Science, and Scopus. Our search included the term "tuberculosis treatment AND interferon-γ release assay". We included studies evaluating the performance of commercial IGRAs (including QFT-GIT, T-SPOT.TB and QFT-Plus) before and after the anti-TB treatment. We performed subgroup analysis based on the age (children, adults), type of TB (active, latent, active and latent, and contacts exposed to MDR defined as MDR LTBI), type of IGRAs (QFT-GIT and T-SPOT.TB), and follow-up interval (2, 3, 4, 6, 9 months). Of the 18 included studies, 12 used QFT-GIT for assessment of IGRA performance after therapy, 1 used T-SPOT.TB, and 3 used both QFT-GIT and T-SPOT.TB. Since then, only two studies have assessed the QFT-Plus performance during therapy. According to the results of the meta-analysis, the pooled rate of positive IGRAs (QFT-GIT and T-SPOT.TB) following anti-TB therapy was estimated at 76% [95% CI 70-81%] and no difference was found compared to the pooled positive rate of IGRAs before initiation of therapy which was 76% [95% CI 60-89%]. The subgroup analysis showed that the pooled rate of positive IGRAs (QFT-GIT and T-SPOT.TB) after anti-TB therapy was significantly higher in monitoring active TB subjects [80% (95% CI 74-88%)] than LTBI [71% (95% CI 70-81%)]. Available data are now sufficient to suggest that monitoring changes in the IGRAs (QFT-GIT and T-SPOT.TB) response during anti-TB treatment may have limited use in evaluating the effectiveness of treatment, while the monitoring changes in QFT-Plus during anti-tubercular treatment are recommended to determine treatment efficacy or for treatment monitoring. Further research is needed to establish the efficacy of this new assay as marker on a larger scale for treatment monitoring.

中文翻译：

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干扰素-γ释放测定法是否可用于监测对抗结核治疗的反应？：系统评价和荟萃分析。

在抗结核（TB）治疗后，评估干扰素-γ释放测定（IGRA）结果的研究数量正在迅速增加。这项研究的目的是调查IGRA（QFT-GIT，T-SPOT.TB，QFT-Plus）在评估抗结核治疗反应方面的潜在用途。我们检索了2011年10月1日至2018年11月18日在PubMed，Web of Science和Scopus中发布的所有英语研究。我们的搜索包括术语“结核病治疗和干扰素-γ释放测定”。我们纳入了评估商业IGRA（包括QFT-GIT，T-SPOT.TB和QFT-Plus）在抗结核治疗前后的性能的研究。我们根据年龄（儿童，成人），结核病类型（活动，潜伏，活动和潜伏以及暴露于定义为MDR LTBI的MDR接触者）进行了亚组分析，IGRA的类型（QFT-GIT和T-SPOT.TB）以及随访间隔（2、3、4、6、9个月）。在18项纳入研究中，有12项使用QFT-GIT评估治疗后的IGRA性能，1项使用T-SPOT.TB，3项同时使用QFT-GIT和T-SPOT.TB。此后，只有两项研究评估了治疗期间QFT-Plus的性能。根据荟萃分析的结果，抗结核病治疗后阳性IGRA（QFT-GIT和T-SPOT.TB）的合并率估计为76％[95％CI 70-81％]，差异无统计学意义。与开始治疗前IGRA的合并阳性率相比为76％[95％CI 60-89％]。亚组分析显示，在监测活动性结核病受试者中，抗结核病治疗后阳性IGRA（QFT-GIT和T-SPOT.TB）的合并率显着高于LTBI [80％（95％CI 74-88％）]。 [71％（95％CI 70-81％）]。现在的可用数据足以表明，在抗结核病治疗期间监测IGRA（QFT-GIT和T-SPOT.TB）反应的变化可能在评估治疗效果方面用途有限，而在监测过程中监测QFT-Plus的变化建议使用抗结核治疗来确定治疗效果或进行治疗监测。需要进一步的研究来确定这种新的检测方法在更大范围内作为治疗监测标记物的功效。