IMR Press / FBL / Volume 27 / Issue 10 / DOI: 10.31083/j.fbl2710282
Open Access Original Research
Performance of LTBI Screening in Patients with Rheumatic Diseases Using Two Different Interferon-Gamma Releasing Assays
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1 Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 200002 Shanghai, China
2 Department of Pharmacy, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 200002 Shanghai, China
*Correspondence: (Jia Li); (Liangjing Lu)
These authors contributed equally.
Academic Editor: Josef Jampílek
Front. Biosci. (Landmark Ed) 2022, 27(10), 282;
Submitted: 13 June 2022 | Revised: 22 August 2022 | Accepted: 25 August 2022 | Published: 8 October 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: To evaluate the concordance between QuantiFERON-TB Gold in-tube test (QFT-GIT) and T-SPOT.TB test (T-SPOT) for the screening of latent tuberculosis infection (LTBI) in patients with rheumatic diseases (RDs). Methods: Patients diagnosed as rheumatic diseases (RDs) with clinical indications for test of interferon gamma release test (IGRA) were prospectively recruited from 2019 to 2020. The consistency of QFT-GIT and T-SPOT was assessed by Kappa analysis and the factors associated with the indeterminate results were explored by multivariable logistic analysis. Results: A total of 108 patients with RDs were enrolled, including 64 patients with systemic lupus erythematosus (SLE) and 44 with inflammatory arthritis (26 with rheumatoid arthritis (RA) and 18 with ankylosing spondylitis (AS)). Poor concordance was confirmed between QFT-GIT and T-SPOT results in patients with SLE (K = 0.175, 95% confidence interval [95% CI] [–0.06, 0.40], p < 0.001), whereas concordance was moderate in patients with inflammatory arthritis (K = 0.539, 95% CI [0.11, 0.88], p < 0.001). Among SLE patients, the ratio of indeterminate results in detecting LTBI was significantly higher by QFT-GIT than by T-SPOT (18.8% vs. 4.7%, p = 0.013), while the statistical difference was not achieved in patients with inflammatory arthritis. The multivariable logistic analysis identified that the presence of lower lymphocyte counts (odds ratio [OR] = 0.81, 95% CI [0.68, 0.97], p = 0.020) was the independent predictor of an indeterminate result of the QFT-GIT in SLE patients. Conclusions: In patients with RDs, the result of screening of LTBI was more definitive by T-SPOT test than QFT, and the concordance was poor especially in the setting of SLE.

latent tuberculosis infection (LTBI)
QuantiFERON-TB Gold in-tube test (QFT-GIT)
rheumatic diseases (RDs)
2017YFC0909000/National Key Research and Development Program “Precision Medicine Research” Key Special Project (Ministry of Science and Technology)
71804109/National Natural Science Foundation Youth Project
SHWSRS(2021)_099/“Rising Stars of Medical Talents” Youth Development Program-Youth Medical Talents
Fig. 1.
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