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Monitoring the efficacy of anti-TB therapy by using the QuantiFERON-TB Gold In tube test

^* National Center of Infectious and Parasitic Diseases, Sofia 1504, ^# University Hospital for Tuberculosis and Lung Diseases, Sofia 1601

CORRESPONDENCE: Roumiana Markova, Dept of Immunology and Allergy, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria

Monitoring the efficacy of anti-TB therapy is crucial for the better control of the spread of MTB infection, but it is often difficult especially for patients without microbiological confirmation of the disease. IGRAs are novel indirect blood tests for M. tuberculosis infection and a promising marker of mycobacterial burden and disease activity.

To describe our experience with the use of the QuantiFERON-TB Gold In tube assay for monitoring of anti-TB therapy in patients with active disease 30 patients with active TB, all HIV-negative and BCG-vaccinated at birth, were studied before and after three and eight months of anti-TB therapy. The whole blood QFT G In tube assay was used to measure the MTB-specific IFN-gamma responses.

Before therapy 28/30 patients had positive results in QFT G In tube (QFT) and two – indeterminate. Three months after initiation of treatment all subjects tested were found positive. On month eight a significant decrease of MTB-specific responses was found in all patients but only 17/30 (56.7%) turned negative in QFT. Three of 13 patients with a positive response at the end of month eight, continued to have microbiological isolation and absence of clinical improvement (fig. 1, table 1).

On the basis of the results obtained, we concluded that the QFT Gold In tube assay could be used in routine clinical practice for monitoring anti-tuberculosis therapy. Further studies including larger number of patients and longer periods of observation are needed.