Evaluation of quantiferon-tb gold plus performance: a systematic review and meta-analysis

Sepideh Benvari,1,* Babak pourakbari,2 Setare mamishi,3 Shima mahmoudi,4

1. Department of Microbiology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
2. Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
3. Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
4. Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran

Abstract

Introduction

Quantiferon-tb gold plus (qft-plus), is a new generation of quantiferon assay that differs from quantiferon-tb gold in-tube test (qft-git). the aim of this study was to compare the performance of the new fda-approved qft-plus interferon (ifn)-γ release assays (igras) with the qft-git version of this assay.

Methods

We searched all studies published in english in electronic databases, including pubmed, scopus, and web of science.

Results

The positive proportion of positive results by qft-plus was higher than qft-git in cured tb cases (82% vs. 73%). the two tests showed a substantial agreement and the majority of the ltbi subjects responded concomitantly to both qft-plus and qft-git. however, qft-plus showed a stronger association with surrogate measures of tb suspects than qft-git. the qft-plus test demonstrated a higher sensitivity than qft-git in the older adults.the sensitivity, specificity, lr+, lr- and dor overall were 94% (95% ci 89–97), 96% (95% ci 94–98), 24.4 (95% ci 15–39), 0.05 (95% ci 0.03–0.11) and 414 (95% ci 251–685), respectively. the area under summary roc curve was 0.99 (95% ci 0.97–0.99).

Conclusion

Qft-plus performs equivalently to the qft-git for detection of patients at risk for ltbi; however, qft-plus test had higher sensitivity than the qft-git test, with similar specificity among the older participants. higher ifn-γ release in tb2 compared to tb1 might be due to with recent ltbi. on the other hand, declining of ifn-γ release in tb2 could be serving as a tool for monitoring of the efficacy of tb therapy.

Keywords

Quantiferon-tb gold plus, ifn-γ release assays, diagnostic accuracy