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Frequency of and risk factors for reversion of QuantiFERON test in healthcare workers in an intermediate-tuberculosis-burden country

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Abstract
Objectives: High-risk healthcare workers (HCWs) are often screened for latent tuberculosis infection (LTBI) using QuantiFERON tests (QFTs), with annual serial tests often showing reversion from positive to negative results. We assessed the frequency of and risk factors for reversion of QFTs in HCWs in an intermediate-tuberculosis burden country. Methods: We enrolled high-risk HCWs at a tertiary-care hospital in South Korea, who were assessed by QFTs at least twice between 2017 and 2019. Results: Of the 1870 HCWs screened, 1542 (82%) had persistent negative results, 229 (12%) had persistent positive results, 53 (3%) showed reversion, and 46 (2%) showed conversion from negative to positive. Multivariate analysis comparing the characteristics of the 229 HCWs with persistent positive results and the 53 who experienced reversion showed that older age (adjusted odds ratio (aOR): 0.96; 95% confi-dence interval (CI): 0.92-0.99), male sex (aOR: 0.29; 95% CI: 0.11-0.78) and high (>0.70 IU/mL) baseline QFT results (aOR: 0.15; 95% CI: 0.07-0.31) were inversely associated with reversion. Using an ROC curve derived cut-off of <0.738 IU/mL, the area under the curve was 0.79. Of 53 HCWs with reversion, 36 (78%) had below 0.738 IU/mL of baseline QFT, while 181 (79%) of 229 HCWs without reversion had above 0.738 IU/mL of baseline QFT. Conclusion: Reversion during serial testing is unlikely in HCWs who are male, older in age, and have higher baseline QFT results. Serial testing without LTBI treatment may be indicated in HCWs who are female, younger and, especially, have lower QFT results. Ja Young Kim, Clin Microbiol Infect 2021;27:1120 (c) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Author(s)
우준희곽선희김성한김양수김은옥김자영심태선이상오정경진정지원조경욱최상호홍민지
Issued Date
2021
Type
Article
Keyword
Healthcare workerInterferon gamma releasing assayLatent tuberculosis infectionQuantiFERON testScreening
DOI
10.1016/j.cmi.2020.09.016
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7928
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2446666283&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Frequency%20of%20and%20risk%20factors%20for%20reversion%20of%20QuantiFERON%20test%20in%20healthcare%20workers%20in%20an%20intermediate-tuberculosis-burden%20country&amp;offset=0&amp;pcAvailability=true
Publisher
CLINICAL MICROBIOLOGY AND INFECTION
Location
EU(유럽연합)
Language
한국어
ISSN
1198-743X
Citation Volume
27
Citation Number
8
Citation Start Page
1120
Citation End Page
1123
Appears in Collections:
Medicine > Medicine
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