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Evolution of Interferon-Gamma Release Assay Results and Submillisievert Chest CT Findings among Close Contacts of Active Pulmonary Tuberculosis Patients

Tuberculosis and Respiratory Diseases 2020년 83권 4호 p.283 ~ 288
윤순호, Mihn Do-CiC, 송진화, 김성아, 임재준,
소속 상세정보
윤순호 ( Yoon Soon-Ho ) - Seoul National University College of Medicine Seoul National University Hospital Department of Radiology
 ( Mihn Do-CiC ) - Seegene Medical Foundation
송진화 ( Song Jin-Hwa ) - Veterans Health Service Medical Center Department of Internal Medicine
김성아 ( Kim Sung-A ) - Seoul National University College of Medicine Department of Internal Medicine
임재준 ( Yim Jae-Joon ) - Seoul National University College of Medicine Department of Internal Medicine

Abstract


Background: Latent tuberculosis (TB) infection among TB contacts is diagnosed using plain chest radiography and interferon-gamma release assays (IGRAs). However, plain chest radiographs often miss active TB, and the results of IGRA could fluctuate over time. The purpose of this study was to elucidate changes in the results of the serial IGRAs and in the findings of the serial submillisievert chest computed tomography (CT) scans among the close contacts of active pulmonary TB patients.

Methods: Patients age 20 or older with active pulmonary TB and their close contacts were invited to participate in this study. Two types of IGRA (QuantiFERON-TB Gold In-Tube assay [QFT-GIT] and the T-SPOT.TB test [T-SPOT]) and submillisievert chest CT scanning were performed at baseline and at 3 and 12 months after enrollment.

Results: In total, 19 close contacts participated in this study. One was diagnosed with active pulmonary TB and was excluded from further analysis. At baseline, four of 18 contacts (22.2%) showed positive results for QFT-GIT and T-SPOT; there were no discordant results. During the follow-up, transient and permanent positive or negative conversions and discordant results between the two types of IGRAs were observed in some patients. Among the 17 contacts who underwent submillisievert chest CT scanning, calcified nodules were identified in seven (41.2%), noncalcified nodules in 14 (82.4%), and bronchiectasis in four (23.5%). Some nodules disappeared over time.

Conclusion: The results of the QFT-GIT and T-SPOT assays and the CT images may change during 1 year of observation of close contacts of the active TB patients.

키워드

Latent Tuberculosis; Tomography, Spiral Computed; Interferon-Gamma Release Tests

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