A QFT-G test was performed at the time of this visit; testing Selleck Fulvestrant was performed at a single large commercial laboratory. The QFT-G test results were interpreted according to the manufacturer’s instructions . Active TB disease was excluded using symptom review, physical examination, chest radiography, and, if necessary, sputum collection for acid-fast bacilli smear microscopy and mycobacterial culture. Clinic providers reviewed
the medical records and extracted data including age, gender, country of origin, length of residence in the United States, TST reaction size measured in millimeters of induration, chest radiograph findings, and risk factors for the development of TB disease. A high-incidence country was defined as a country with an incidence of ≥20 cases of acid-fast smear-positive pulmonary TB per Rapamycin ic50 100,000 persons . A step-wise logistic regression was used to determine the odds ratios (ORs) for demographic and clinical factors that were predictive of a positive QFT-G result. Age and TST induration were modeled as continuous variables. A P value of <0.05 was considered significant. A review of the study determined that it entailed an assessment of routine public health practice
and was not considered human subjects research. The Institutional Review Board of St. Francis Hospital and Medical Center (Hartford, CT) approved this retrospective cohort study. A total of 100 BCG-vaccinated adults who were referred to the pulmonary clinic because of a positive TST result were included in the study. The median patient age was 34 years, nearly half (46%) were male, and the study participants had been in the United States for a median duration of 4.5 years (range 0–44 years). The participants were from 42 different countries representing the Americas (47%), Europe (20%), Africa (18%), Southeast Asia (6%), the western Pacific (6%), and the eastern Mediterranean (3%). Their birth countries had a median TB incidence of 37 cases per 100,000 population (range 2–312 cases); 57% were from countries
with a high incidence of TB. The median TST induration was 15 mm. Among the 100 persons with positive TST results, 30 (30%) also had a positive QFT-G Mannose-binding protein-associated serine protease result (Fig. 1). One QFT-G result was indeterminate, but a repeat test was negative. Twenty-six (46%) of the 57 adults from high-incidence countries were QFT-G positive (Table 1); in contrast, 4 of 43 adults (9%) from low-incidence countries were positive (OR = 8.2; 95% confidence interval (CI), 2.4–31.1). None had active TB disease. A logistic regression was used to compare tuberculin reactivity. Persons with a TST induration ≥ 16 mm had a more than six fold greater likelihood of having a positive QFT-G result than persons with a smaller TST induration (Table 2). The combination of being from a high-incidence country and having a TST induration ≥ 16 mm also strongly predicted QFT-G positivity (Table 2).