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Clinical and Diagnostic Laboratory Immunology, November 1999, p. 934-937, Vol. 6, No. 6
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Tuberculin-Purified Protein Derivative-, MPT-64-, and ESAT-6-Stimulated Gamma Interferon Responses in Medical Students before and after Mycobacterium bovis BCG Vaccination and in Patients with Tuberculosis

P. D. R. Johnson,1,* R. L. Stuart,1 M. L. Grayson,1 D. Olden,1 A. Clancy,2 P. Ravn,3 P. Andersen,3 W. J. Britton,4 and J. S. Rothel2

Department of Infectious Diseases and Clinical Epidemiology, Monash Medical Centre, Clayton, Victoria,1 Biosciences Division, CSL Limited, Melbourne, Victoria,2 and Centenary Institute of Cancer Medicine and Cell Biology, Newtown, New South Wales,4 Australia, and Statens Serum Institute, Copenhagen, Denmark3

Received 18 May 1999/Returned for modification 21 July 1999/Accepted 10 August 1999

QuantiFERON-TB (QIFN) (CSL Limited) is a whole-blood assay for the recognition of infection with Mycobacterium tuberculosis. QIFN measures gamma interferon (IFN-gamma ) production when purified protein derivatives (PPDs) of mycobacteria are incubated with venous blood samples. The specificity of QIFN in medical students before and after BCG immunization was assessed, and sensitivity in patients with tuberculosis was assessed. Antigens were PPD derived from M. tuberculosis and two M. tuberculosis-specific proteins, ESAT-6 and MPT-64. Of 60 medical students, all of whom had 0-mm tuberculin skin tests (TSTs) at study entry, 58 (97%) were initially classified as negative for M. tuberculosis infection by PPD QIFN. Five months after BCG immunization, 7 of 54 students (13%) had a TST result of >= 10 mm and 11 of 54 students (20%) tested positive by PPD QIFN. ESAT-6- and MPT-64-stimulated IFN-gamma responses in the medical students were negative prior to and after BCG immunization. For patients with active tuberculosis, 12 of 19 (63%) were positive by PPD QIFN, 11 of 19 (58%) were positive by ESAT-6 QIFN, and 0 of 12 were positive by MPT-64 QIFN. In conclusion, PPD QIFN was negative in 97% of a low-risk population who had not received BCG and who had negative TSTs. The specificities of both the TST and PPD QIFN were reduced following BCG immunization. PPD QIFN and ESAT-6 QIFN were of similar and moderate sensitivity in patients with active tuberculosis, but ESAT-6 QIFN is likely to be more specific because it is not influenced by past BCG exposure.

* Corresponding author. Mailing address: Department of Infectious Diseases and Clinical Epidemiology, Monash Medical Centre, Clayton 3168, Victoria, Australia. Phone: 613 9594 4563. Fax: 613 9594 4533. E-mail Paul.Johnson{at}med.monash.edu.au.

Clinical and Diagnostic Laboratory Immunology, November 1999, p. 934-937, Vol. 6, No. 6
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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