Comparison of whole-blood interferon-γ assay and flow cytometry for the detection of tuberculosis infection

SummaryObjectiveLimited data exist about the performance of the intracellular cytokine flow cytometry (ICCFC) with respect to that of the commercial interferon-γ release assay for the detection of tuberculosis (TB) infection. Here, we compared the diagnostic accuracy of an ICCFC with that of the QuantiFERON-TB Gold In-Tube (QFT-IT) test for the detection of TB in a clinical setting.MethodsEighty-nine patients suspected of having TB were prospectively included. Both the QFT-IT test and ICCFC were performed for all subjects (TB [n = 65] and non-TB [n = 24]). Ten healthy controls who tested negative by QFT-IT were also assessed by ICCFC.ResultsThe sensitivity of the ICCFC was significantly superior to that of the QFT-IT test (91% vs. 78%, p = 0.021). The clinical characteristics of patients in whom the ICCFC exhibited superior sensitivity compared to the QFT-IT test included advanced age, lymphocytopenia, hypoalbuminemia, increased C-reactive protein level, a positive acid-fast bacilli smear of respiratory specimens, and radiographically more extensive disease.ConclusionsICCFC might be a preferable technique for the detection of TB infection, particularly in patients with conditions associated with impaired performance of the QFT-IT test.