Prognostic value of interferon gamma release assays and tuberculin skin test in predicting the development of active tuberculosis: the uk predict tb cohort study

Abubakar, I., Drobniewski, F., Southern, J., Sitch, A. J., Jackson, C., Lipman, M, Deeks, J. J., Griffiths, C., Bothamley, G., Lynn, W., and others. (2017) Prognostic value of interferon gamma release assays and tuberculin skin test in predicting the development of active tuberculosis: the uk predict tb cohort study. In: Thorax. British Thoracic Society Winter Meeting 2017. 72 (Supp 3). BMJ (doi:10.1136/thoraxjnl-2017-210983.37) (Access to this publication is currently restricted. You may be able to access a copy if URLs are provided) (KAR id:112884)

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Official URL: https://doi.org/10.1136/thoraxjnl-2017-210983.37

Abstract

Background Tackling tuberculosis (TB) requires testing and treatment of high-risk groups for latent tuberculosis infection. We estimated the predictive values of the tuberculin skin test (TST) and interferon gamma release assays (IGRAs) for development of active TB in migrants and contacts of active TB patients in the UK.

Methods Participants were prospectively recruited in clinics and the community and followed for a median of 2.9 years. We administered IGRAs (Quantiferon Gold In-Tube [QFT-GIT] and T-SPOT.TB) and TST (with 3 thresholds: 5 mm (TST5), 10 mm (TST10) and TST15 (5 mm in BCG-naïve, 15 mm in vaccinated). Potential incident TB cases were identified by telephone interview and national TB databases and confirmed by medical note review.

Results Ninety-seven (1.0%) of 9610 participants developed active TB (77 of 6386 who had Results for T-SPOT.TB, QFT-GIT and TST). All tests had very low incidence in test negatives (1.2–1.6 per 1000 per year). Incidence rates in test positives were highest for TSpot.TB (13.2 95% CI: (9.9–17.4)), TST15 (11.1 (8.3,14.6)) and QFT.GIT (10.1 (7.4,13.4)); positive test Results for these tests were significantly more predictive of progression than TST10 and TST5, TSpot.TB was also higher than QFT.GIT. TST5 predicted more at high risk (55%) than TST10 (45%), TSpot.TB (33%), TST15 (38%) and QFT.GIT (31%).

Conclusions IGRA-based or TST15 strategies are most suited for population screening in low-risk populations. Although TST5 and TST10 detect more TB cases this is at the cost of more individuals being classified at high risk with lower positive predictive values.

Item Type:	Conference or workshop item (Other)
DOI/Identification number:	10.1136/thoraxjnl-2017-210983.37
Projects:	UK PREDICT study
Additional information:	abstract only
Subjects:	H Social Sciences
Institutional Unit:	Schools > School of Social Sciences > Centre for Health Services Studies
Former Institutional Unit:	There are no former institutional units.
Funders:	National Institute for Health Research (https://ror.org/0187kwz08)
Depositing User:	Melanie Rees-Roberts
Date Deposited:	27 Jan 2026 14:13 UTC
Last Modified:	28 Jan 2026 10:51 UTC
Resource URI:	https://kar.kent.ac.uk/id/eprint/112884 (The current URI for this page, for reference purposes)

University of Kent Author Information

Rees-Roberts, M..

Creator's ORCID:	https://orcid.org/0000-0002-7121-0414
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