QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study

Background: healthcare workers (HCWs) are at higher risk of being exposed to tuberculosis (TB). The aim of this study was to estimate LTBI prevalence and evaluate associated risk factors among Italian HCWs using a new generation IGRA test, Quantiferon Plus (QTF-Plus), providing also an analytical ev...

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Main Authors: Luca Coppeta, Savino Baldi, Giuseppina Somma, Elisabetta Tursi, Sara Policardo, Ottavia Baldi, Piergiorgio Lieto, Antonio Pietroiusti, Andrea Magrini
Format: Article
Language:English
Published: Milano University Press 2019-06-01
Series:Epidemiology, Biostatistics and Public Health
Online Access:https://ebph.it/article/view/13123
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author Luca Coppeta
Savino Baldi
Giuseppina Somma
Elisabetta Tursi
Sara Policardo
Ottavia Baldi
Piergiorgio Lieto
Antonio Pietroiusti
Andrea Magrini
author_facet Luca Coppeta
Savino Baldi
Giuseppina Somma
Elisabetta Tursi
Sara Policardo
Ottavia Baldi
Piergiorgio Lieto
Antonio Pietroiusti
Andrea Magrini
author_sort Luca Coppeta
collection DOAJ
description Background: healthcare workers (HCWs) are at higher risk of being exposed to tuberculosis (TB). The aim of this study was to estimate LTBI prevalence and evaluate associated risk factors among Italian HCWs using a new generation IGRA test, Quantiferon Plus (QTF-Plus), providing also an analytical evaluation of this test. Methods: this cross-sectional study was conducted during the annual health surveillance program performed in 2017, evaluating 1470 HCWs of a teaching hospital in Rome, tested with QTF-Plus. A standardized questionnaire was collected for multivariate risk analysis. The independent variables associated with a higher frequency of LTBI were tested in a multivariate logistic regression model. Results: LTBI was diagnosed in 50 out of 1470 (3.4%) of HCWs. The male gender and age>40 years were significantly associated with the risk of LTBI. The levels of interferon-γ were significantly lower in subjects with a recent conversion than in those with an older positivity. Moreover, interferon-γ values exceeding 8 IU/ml were recorded in 8 out of 35 remote subjects but in no recent subjects. The concordance between TB1 and TB2 results was 88%, while in 6 out of 50 subjects we found a discrepancy. Conclusion: the LTBI condition among Italian HCWs was very low. In subjects with discordant outcomes between TB1 and TB2, especially when the test values are close to the cut-off, is recommended a repetition of the test to confirm its positivity. Key words: tuberculosis, latent tuberculosis infection, interferon-gamma release assay, quantiferon plus, healthcare workers
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spelling doaj-art-01e0e360bcaa450ba11127f24290b9902025-08-20T02:01:46ZengMilano University PressEpidemiology, Biostatistics and Public Health2282-09302019-06-0116210.2427/1312311211QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional studyLuca Coppeta0Savino Baldi1Giuseppina Somma2Elisabetta Tursi3Sara Policardo4Ottavia Baldi5Piergiorgio Lieto6Antonio Pietroiusti7Andrea Magrini8Department of Biomedicine and Prevention, University of Rome "Tor Vergata”, Viale Montpellier 1, RomaDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata”, Viale Montpellier 1, RomaDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata”, Viale Montpellier 1, RomaDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata”, Viale Montpellier 1, RomaDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata”, Viale Montpellier 1, RomaDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata”, Viale Montpellier 1, RomaDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata”, Viale Montpellier 1, RomaDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata”, Viale Montpellier 1, RomaDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata”, Viale Montpellier 1, RomaBackground: healthcare workers (HCWs) are at higher risk of being exposed to tuberculosis (TB). The aim of this study was to estimate LTBI prevalence and evaluate associated risk factors among Italian HCWs using a new generation IGRA test, Quantiferon Plus (QTF-Plus), providing also an analytical evaluation of this test. Methods: this cross-sectional study was conducted during the annual health surveillance program performed in 2017, evaluating 1470 HCWs of a teaching hospital in Rome, tested with QTF-Plus. A standardized questionnaire was collected for multivariate risk analysis. The independent variables associated with a higher frequency of LTBI were tested in a multivariate logistic regression model. Results: LTBI was diagnosed in 50 out of 1470 (3.4%) of HCWs. The male gender and age>40 years were significantly associated with the risk of LTBI. The levels of interferon-γ were significantly lower in subjects with a recent conversion than in those with an older positivity. Moreover, interferon-γ values exceeding 8 IU/ml were recorded in 8 out of 35 remote subjects but in no recent subjects. The concordance between TB1 and TB2 results was 88%, while in 6 out of 50 subjects we found a discrepancy. Conclusion: the LTBI condition among Italian HCWs was very low. In subjects with discordant outcomes between TB1 and TB2, especially when the test values are close to the cut-off, is recommended a repetition of the test to confirm its positivity. Key words: tuberculosis, latent tuberculosis infection, interferon-gamma release assay, quantiferon plus, healthcare workershttps://ebph.it/article/view/13123
spellingShingle Luca Coppeta
Savino Baldi
Giuseppina Somma
Elisabetta Tursi
Sara Policardo
Ottavia Baldi
Piergiorgio Lieto
Antonio Pietroiusti
Andrea Magrini
QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study
Epidemiology, Biostatistics and Public Health
title QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study
title_full QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study
title_fullStr QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study
title_full_unstemmed QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study
title_short QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study
title_sort quantiferon tb gold plus evaluation for latent tuberculosis infection among italian healthcare workers a cross sectional study
url https://ebph.it/article/view/13123
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