{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:16:54Z","timestamp":1787008614631,"version":"build-2736575974"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Six One Project\u201d Top-Notch Talent Research Project","award":["LGY2017083"],"award-info":[{"award-number":["LGY2017083"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Discordance between the QuantiFERON-TB Gold In-tube (QFT) and tuberculin skin test (TST) is not well understood. We aimed to identify the factors that determine discordance between the TST and QFT when compared to either TST+QFT+ or TST-QFT- results in a medium tuberculosis (TB) burden setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a population-based study in Eastern China and administered TSTs and QFTs to participants. We calculated kappa values while constructing multivariable logistic regression models to evaluate predictors of test discordance. We analyzed the predictive value of discordant and concordant test results for progression to TB over 6 years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 5405 participants were enrolled; 2043 (37.8%) and 1104 (20.4%) were TST and QFT positive, respectively. There was fair agreement between the TST and the QFT (kappa values between 0.30\u20130.39 at different TST cutoffs). Agreement was lower among participants vaccinated with Bacillus Calmette-Guerin (BCG; \u03ba, 0.17 versus 0.47 in nonvaccinated participants). TST+QFT- results were associated with decreasing age, smoking, undiagnosed diabetes, and BCG vaccination (adjusted odds ratio, 1.45; 95% confidence interval [CI], 1.11\u20131.90). TST-QFT+ results were associated with increasing age, male sex, smoking, and diagnosed diabetes. Compared to participants with TST-QFT- results, QFT+ and TST+QFT+ participants were 6.3 (95% CI, 1.9\u201320.4) and 7.5 (95%CI, 2.3\u201325.1) times more likely to progress to TB, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this population-based study of over 5000 participants from a medium TB burden region, the test agreement between QFT and TST was fair overall and we found multiple novel predictors of discordant QFT\/TST results. QFT provides a substantial improvement to the TST among these populations and was multi-fold better at predicting progression to TB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa519","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T15:52:12Z","timestamp":1588175532000},"page":"2006-2015","source":"Crossref","is-referenced-by-count":30,"title":["Predictors of Discordant Tuberculin Skin Test and QuantiFERON-TB Gold In-tube Results in Eastern China: A Population-based, Cohort Study"],"prefix":"10.1093","volume":"72","author":[{"given":"Peng","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People\u2019s Republic of China"},{"name":"Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Martinez","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Center for Disease Control and Prevention of Danyang City, Zhenjiang, Jiangsu Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,5]]},"reference":[{"key":"2021060106100619600_CIT0001","volume-title":"Factsheet: post-2015 global TB strategy and targets","author":"World Health Organization","year":"2015"},{"key":"2021060106100619600_CIT0002","article-title":"Guidance for national tuberculosis programmes on the management of tuberculosis in children [report number 9241548746]","author":"World Health Organization.","year":"2014"},{"key":"2021060106100619600_CIT0003","doi-asserted-by":"crossref","first-page":"2344","DOI":"10.1016\/S0140-6736(15)00323-2","article-title":"Controlling the seedbeds of tuberculosis: diagnosis and treatment of tuberculosis infection","volume":"386","author":"Rangaka","year":"2015","journal-title":"Lancet"},{"key":"2021060106100619600_CIT0004","doi-asserted-by":"crossref","first-page":"e1002152","DOI":"10.1371\/journal.pmed.1002152","article-title":"The global burden of latent tuberculosis infection: a re-estimation using mathematical modelling","volume":"13","author":"Houben","year":"2016","journal-title":"PLOS Med"},{"key":"2021060106100619600_CIT0005","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1128\/JCM.02803-15","article-title":"Interferon gamma release assays for latent tuberculosis: what are the sources of variability?","volume":"54","author":"Banaei","year":"2016","journal-title":"J Clin Microbiol"},{"key":"2021060106100619600_CIT0006","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1128\/CMR.00034-13","article-title":"Gamma interferon release assays for detection of Mycobacterium tuberculosis infection","volume":"27","author":"Pai","year":"2014","journal-title":"Clin Microbiol Rev"},{"key":"2021060106100619600_CIT0007","doi-asserted-by":"crossref","first-page":"e0003623","DOI":"10.1371\/journal.pntd.0003623","article-title":"The epidemiology and geographic distribution of nontuberculous mycobacteria clinical isolates from sputum samples in the eastern region of China","volume":"9","author":"Shao","year":"2015","journal-title":"PLOS Negl Trop Dis"},{"key":"2021060106100619600_CIT0008","doi-asserted-by":"crossref","first-page":"340","DOI":"10.7326\/0003-4819-146-5-200703060-00006","article-title":"Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research","volume":"146","author":"Menzies","year":"2007","journal-title":"Ann Intern Med"},{"key":"2021060106100619600_CIT0009","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/S1473-3099(07)70086-5","article-title":"T-cell assays for the diagnosis of latent tuberculosis infection: moving the research agenda forward","volume":"7","author":"Pai","year":"2007","journal-title":"Lancet Infect Dis"},{"key":"2021060106100619600_CIT0010","first-page":"1","article-title":"Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection - United States, 2010","volume":"59","author":"Mazurek","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2021060106100619600_CIT0011","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1164\/rccm.201508-1560OC","article-title":"Latent tuberculosis infection test agreement in the national health and nutrition examination survey","volume":"194","author":"Ghassemieh","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2021060106100619600_CIT0012","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.tmaid.2018.07.009","article-title":"Utility of tuberculin skin test and IGRA for tuberculosis screening in internationally adopted children: Retrospective analysis from a single center in Florence, Italy","volume":"28","author":"Mastrolia","year":"2019","journal-title":"Travel Med Infect Dis"},{"key":"2021060106100619600_CIT0013","doi-asserted-by":"crossref","first-page":"e102773","DOI":"10.1371\/journal.pone.0102773","article-title":"Comparison of interferon-\u03b3 release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers","volume":"9","author":"de Souza","year":"2014","journal-title":"PLOS One"},{"key":"2021060106100619600_CIT0014","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s12879-019-3745-5","article-title":"Predictors of discordant latent tuberculosis infection test results amongst South African health care workers","volume":"19","author":"Adams","year":"2019","journal-title":"BMC Infect Dis"},{"key":"2021060106100619600_CIT0015","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.5588\/ijtld.10.0650","article-title":"Predictors of discordant tuberculin skin test and QuantiFERON\u00ae-TB Gold In-Tube results in various high-risk groups","volume":"15","author":"Weinfurter","year":"2011","journal-title":"Int J Tuberc Lung Dis"},{"key":"2021060106100619600_CIT0016","doi-asserted-by":"crossref","first-page":"e0199360","DOI":"10.1371\/journal.pone.0199360","article-title":"Cohort for Tuberculosis Research by the Indo-US Medical Partnership Study Team. Tuberculin skin test and QuantiFERON-Gold In Tube assay for diagnosis of latent TB infection among household contacts of pulmonary TB patients in high TB burden setting","volume":"13","author":"Chandrasekaran","year":"2018","journal-title":"PLOS One"},{"key":"2021060106100619600_CIT0017","doi-asserted-by":"crossref","first-page":"e3227","DOI":"10.1002\/dmrr.3227","article-title":"Undiagnosed diabetes mellitus and tuberculosis infection: a population-based, observational study from Eastern China","volume":"36","author":"Liu","year":"2019","journal-title":"Diabetes Metab Res Rev"},{"key":"2021060106100619600_CIT0018","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/S1473-3099(14)71085-0","article-title":"Latent tuberculosis infection in rural China: baseline results of a population-based, multicentre, prospective cohort study","volume":"15","author":"Gao","year":"2015","journal-title":"Lancet Infect Dis"},{"key":"2021060106100619600_CIT0019","first-page":"320","article-title":"Tuberculin reactivity in adult BCG-vaccinated subjects: a cross-sectional study","volume":"7","author":"Bugiani","year":"2003","journal-title":"Int J Tuberc Lung Dis"},{"key":"2021060106100619600_CIT0020","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1136\/thorax.57.9.804","article-title":"A meta-analysis of the effect of Bacille Calmette Gu\u00e9rin vaccination on tuberculin skin test measurements","volume":"57","author":"Wang","year":"2002","journal-title":"Thorax"},{"key":"2021060106100619600_CIT0021","doi-asserted-by":"crossref","first-page":"2756","DOI":"10.1001\/jama.293.22.2756","article-title":"Discrepancy between the tuberculin skin test and the whole-blood interferon gamma assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country","volume":"293","author":"Kang","year":"2005","journal-title":"JAMA"},{"key":"2021060106100619600_CIT0022","first-page":"1192","article-title":"False-positive tuberculin skin tests: what is the absolute effect of BCG and non-tuberculous mycobacteria?","volume":"10","author":"Farhat","year":"2006","journal-title":"Int J Tuberc Lung Dis"},{"key":"2021060106100619600_CIT0023","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/S0140-6736(00)02742-2","article-title":"Specific immune-based diagnosis of tuberculosis","volume":"356","author":"Andersen","year":"2000","journal-title":"Lancet"},{"key":"2021060106100619600_CIT0024","first-page":"725","article-title":"Diagnostic standards and classification of tuberculosis","volume":"142","author":"Bass","year":"1990","journal-title":"Am J Respir Crit Care Med"},{"key":"2021060106100619600_CIT0025","volume-title":"Guidelines for the diagnosis of latent tuberculosis infection for the 21st century: CME certified monograph. New Jersey: New Jersey Medical School Global Tuberculosis Institute","author":"Reichman","year":"2008"},{"key":"2021060106100619600_CIT0026","volume-title":"Guidance for national tuberculosis programmes on the management of tuberculosis in children [","author":"Organization","year":"2014"},{"key":"2021060106100619600_CIT0027","first-page":"582","article-title":"Reduced sensitivity of the QuantiFERON\u00ae test in diabetic patients with smear-negative tuberculosis","volume-title":"Int J Tuberc Lung Dis","author":"Choi","year":"2015"},{"key":"2021060106100619600_CIT0028","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.1093\/cid\/cix632","article-title":"Glycemic control and the prevalence of tuberculosis infection: a population-based observational study","volume":"65","author":"Martinez","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2021060106100619600_CIT0029","doi-asserted-by":"crossref","first-page":"582","DOI":"10.5588\/ijtld.14.0553","article-title":"Reduced sensitivity of the QuantiFERON(\u00ae) test in diabetic patients with smear-negative tuberculosis","volume":"19","author":"Choi","year":"2015","journal-title":"Int J Tuberc Lung Dis"},{"key":"2021060106100619600_CIT0030","doi-asserted-by":"crossref","first-page":"e0175183","DOI":"10.1371\/journal.pone.0175183","article-title":"A dose-response relationship of smoking with tuberculosis infection: a cross-sectional study among 21\u2005008 rural residents in China","volume":"12","author":"Zhang","year":"2017","journal-title":"PLOS One"},{"key":"2021060106100619600_CIT0031","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.1371\/journal.pmed.0040020","article-title":"Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis","volume":"4","author":"Lin","year":"2007","journal-title":"PLOS Med"},{"key":"2021060106100619600_CIT0032","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1164\/ajrccm.159.1.9801120","article-title":"Interpretation of repeated tuberculin tests. Boosting, conversion, and reversion","volume":"159","author":"Menzies","year":"1999","journal-title":"Am J Respir Crit Care Med"},{"key":"2021060106100619600_CIT0033","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1378\/chest.101.2.447","article-title":"Four-stage tuberculin testing in elderly subjects induces age-dependent progressive boosting","volume":"101","author":"Van den Brande","year":"1992","journal-title":"Chest"},{"key":"2021060106100619600_CIT0034","doi-asserted-by":"crossref","first-page":"e2665","DOI":"10.1371\/journal.pone.0002665","article-title":"Interferon-gamma release assay for the diagnosis of latent TB infection\u2013analysis of discordant results, when compared to the tuberculin skin test","volume":"3","author":"Nienhaus","year":"2008","journal-title":"PLOS One"},{"key":"2021060106100619600_CIT0035","first-page":"1","article-title":"Four decades of studies on population aging in China","author":"Lu","year":"2019","journal-title":"China Popul Dev Stud"},{"key":"2021060106100619600_CIT0036","doi-asserted-by":"crossref","first-page":"l5770","DOI":"10.1136\/bmj.l5770","article-title":"Is Mycobacterium tuberculosis infection life long?","volume":"367","author":"Behr","year":"2019","journal-title":"BMJ"},{"key":"2021060106100619600_CIT0037","doi-asserted-by":"crossref","first-page":"1701267","DOI":"10.1183\/13993003.01267-2017","article-title":"Frequency and significance of indeterminate and borderline QuantiFERON Gold TB IGRA results","volume":"50","author":"Brown","year":"2017","journal-title":"Eur Respir J"},{"key":"2021060106100619600_CIT0038","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/S2213-2600(17)30060-7","article-title":"Serial QuantiFERON testing and tuberculosis disease risk among young children: an observational cohort study","volume":"5","author":"Andrews","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2021060106100619600_CIT0039","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.5588\/ijtld.18.0073","article-title":"Performance of the QuantiFERON((R))-TB Gold In-Tube assay in tuberculin skin test converters: a prospective cohort study","volume":"22","author":"Castellanos","year":"2018","journal-title":"Int J Tuberc Lung Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaa519\/33392572\/ciaa519.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/72\/11\/2006\/38389189\/ciaa519.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/72\/11\/2006\/38389189\/ciaa519.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T09:17:40Z","timestamp":1696065460000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/72\/11\/2006\/5830771"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,5]]},"references-count":39,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,5,5]]},"published-print":{"date-parts":[[2021,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaa519","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,6,1]]},"published":{"date-parts":[[2020,5,5]]}}}