Serial testing with the interferon-γ release assay in Portuguese healthcare workers

Int Arch Occup Environ Health. 2011 Apr;84(4):461-9. doi: 10.1007/s00420-010-0571-x. Epub 2010 Aug 19.


Objectives: Evidence for the utility of the new Mycobacterium tuberculosis (MTB) specific IFN-γ release assays in diagnosing latent tuberculosis infection (LTBI) is growing. However, data concerning conversion and reversion rates in serial testing of healthcare workers (HCWs) with an interferon-γ release assay are sparse.

Methods: Between February 2007 and September 2009, 670 HCWs in the University Hospital of Porto, Portugal were tested at least twice with QuantiFERON-TB® Gold In-Tube (QFT) for LTBI. The tuberculin skin test (TST) was performed simultaneously. QFT was considered positive if INF-γ ≥0.35 IU/mL. TST conversion was defined as an increase ≥10 or ≥6 mm compared to a baseline TST <10 mm.

Results: The second QFT was positive in 4.8% of the 376 HCWs with an INF-γ concentration at baseline below 0.1 IU/mL but in 48.8% of the 41 HCWs with an INF-γ concentration of 0.2 to <0.35 IU/mL. Out of 74 HCWs with a baseline INF-γ concentration ≥3.0 IU/mL, 4 (5.4%) reversed while 27 out of 55 HCWs (49%) with a baseline INF-γ concentration ≥0.35 to <0.7 IU/mL reversed to a negative QFT. Those 61 HCWs with TST conversion (increase ≥10 mm) were most often (78.7%) negative in both consecutive QFTs.

Conclusion: Our data suggests the use of an uncertainty zone between 0.2 and 0.7 IU/mL in serial testing with QFT. As long as the knowledge regarding disease progression in QFT-positive persons is limited, persons pertaining to this zone should be retested before being offered preventive chemotherapy.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Health Personnel*
  • Humans
  • Interferon-gamma / blood*
  • Limit of Detection
  • Male
  • Mass Screening
  • Middle Aged
  • Mycobacterium tuberculosis / immunology
  • Mycobacterium tuberculosis / isolation & purification
  • Portugal / epidemiology
  • Reagent Kits, Diagnostic
  • Tuberculin Test / methods*
  • Tuberculosis / diagnosis*
  • Tuberculosis / epidemiology
  • Tuberculosis / microbiology
  • Young Adult


  • Reagent Kits, Diagnostic
  • Interferon-gamma