• P Weinfurter, H M Blumberg, G Goldbaum, R Royce, J Pang, J Tapia, J Bethel, G H Mazurek, S Toney, R Albalak, and Tuberculosis Epidemiological Studies Consortium.
• Westat, Rockville, MD, USA. cwa1@cdc.gov
• Int. J. Tuberc. Lung Dis. 2011 Aug 1; 15 (8): 1056-61.

SettingPersons in whom targeted testing for latent tuberculosis infection (LTBI) is recommended in Seattle, Washington; Atlanta, Georgia; and central North Carolina, United States.ObjectiveTo compare the performance of an interferon-gamma release assay (QuantiFERON®-TB Gold In-Tube [QFT-GIT]) with the tuberculin skin test (TST) among foreign-born, homeless, human immunodeficiency virus (HIV) infected and substance abuse persons tested for LTBI.DesignA cross-sectional study requiring participants to have a blood test, a TST and data collected.ResultsOf 1653 persons, 19.5% were TST-positive and 14.0% were QFT-GIT-positive. Overall concordance was moderate (kappa 0.53; 95%CI 0.47-0.58). Compared to concordant positive results, TST+/QFT-GIT- discordance was associated with HIV infection and sex, while TST-/QFT-GIT+ discordance was associated with HIV and inversely associated with foreign birth. Compared to concordant negative results, TST-/QFT-GIT+ discordance was associated with foreign birth and age ≥50 years, while TST+/QFT-GIT-discordance was associated with foreign birth, age 30-49 years, being Black and inversely associated with HIV. HIV infection was significantly associated with indeterminate QFT-GIT results.ConclusionQFT-GIT may be an improvement over the TST for diagnosing LTBI in foreign-born and older persons, and may be as useful as the TST in HIV-infected persons. The sensitivity of both tests may be low in HIV-infected persons.

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