RT Journal Article
SR Electronic
T1 Discordance of two interferon-γ release assays and tuberculin skin test in patients with uveitis
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 1649
OP 1653
DO 10.1136/bjophthalmol-2014-305229
VO 98
IS 12
A1 Marcus Ang
A1 Sieh Yean Kiew
A1 Wan Ling Wong
A1 Soon-Phaik Chee
YR 2014
UL http://bjo.bmj.com/content/98/12/1649.abstract
AB Aims To describe interferon-γ release assay (IGRA) and IGRA/tuberculin skin test (TST) discordance and their associated factors in patients with uveitis. Methods Prospective study of 102 consecutive new patients presenting with uveitis to a tertiary referral centre. All patients underwent a complete ocular and systemic examination at presentation, with QuantiFERON-Gold in-tube (QFT), T-SPOT.TB and TST performed. Discordant results of TST/QFT, TST/T-SPOT.TB and QFT/T-SPOT.TB were analysed. Binary logistic regression was used to identify factors associated with discordant results. Results There was fair agreement between TST and T-SPOT.TB (κ=0.371, p<0.001); moderate agreement between TST and QFT (κ=0.471, p<0.001). Both IGRAs showed good agreement (κ=0.668, p<0.001). The discordance rate between the TST/QFT was 26.5%, while TST/T-SPOT.TB was 31.4%. The discordance rate between the IGRAs was 16.7%. There was a significant association between TST/IGRA discordance with increasing age (OR 0.95, 95% CI 0.92 to 0.99; p=0.022), less likely with panuveitis (OR 0.18, 95% CI 0.04 to 0.86; p=0.032), and with Indian ethnicity (OR 14.07, 95% CI 1.45 to 137.03; p=0.023). Conclusions Discordance of IGRA and TST results is common and requires further study. In our study in patients with uveitis, we found that ethnicity, age, and type of uveitis were some significant factors associated with TST/IGRA discordance, which may need to be taken into consideration when interpreting these results.