{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:06:41Z","timestamp":1780592801676,"version":"3.54.1"},"reference-count":26,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T00:00:00Z","timestamp":1496275200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Although launched in 2015, little is known about the accuracy of QuantiFERON-TB Gold-Plus (QFT-Plus) for diagnosis of latent<jats:named-content content-type=\"genus-species\">M. tuberculosis<\/jats:named-content>infection (LTBI). Unlike its predecessor, QFT-Plus utilizes two antigen tubes to elicit an immune response from CD4<jats:sup>+<\/jats:sup>and CD8<jats:sup>+<\/jats:sup>T lymphocytes. We conducted a cross-sectional study in low-risk health care workers (HCWs) at a single U.S. center to compare QFT-Plus to QuantiFERON-TB Gold in-tube (QFT). A total of 989 HCWs were tested with both QFT and QFT-Plus. Risk factors for LTBI were obtained from a questionnaire. QFT-Plus was considered positive if either antigen tube 1 (TB1) or TB2 tested positive, per the manufacturer's recommendations, or if both TB1 and TB2 tested positive, using a conservative definition. Results were compared using Cohen's kappa and linear regression, respectively. Agreement of QFT with QFT-Plus was high, at 95.6% (95% confidence interval [CI], 94.3 to 96.9; kappa, 0.57). The majority of discordant results between QFT and QFT-Plus TB1 (84.8%) and QFT and QFT-Plus TB2 (88.6%) fell within the range of 0.2 to 0.7 IU\/ml. The positivity rate in 626 HCWs with no identifiable risk factors and no self-reported history of positive LTBI tests was 2.1% (CI, 1.0 to 3.2) and 3.0% (CI, 1.7 to 4.3) with QFT and QFT-Plus, respectively. A conservative definition of a QFT-Plus-positive result yielded a positivity rate of 1.0% (CI, 0.2 to 1.7;<jats:italic>P<\/jats:italic>value of 0.0002 versus QFT-Plus and 0.07 versus QFT). On follow-up testing, of 11 HCWs with discordant QFT-Plus results, 90.9% (10\/11) had a negative QFT result. The QFT-Plus assay showed a high degree of agreement with QFT in U.S. HCWs. A conservative interpretation of QFT-Plus eliminated nearly all nonreproducible positive results in low-risk HCWs. Larger studies are needed to validate the latter finding and to more clearly define conditions under which a conservative interpretation can be used to minimize nonreproducible positive results in low-risk populations.<\/jats:p>","DOI":"10.1128\/jcm.02498-16","type":"journal-article","created":{"date-parts":[[2017,3,16]],"date-time":"2017-03-16T00:50:20Z","timestamp":1489625420000},"page":"1650-1657","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":53,"title":["Evaluation of QuantiFERON-TB Gold-Plus in Health Care Workers in a Low-Incidence Setting"],"prefix":"10.1128","volume":"55","author":[{"given":"Hee-Won","family":"Moon","sequence":"first","affiliation":[{"name":"Department of Pathology, Division of Infectious Diseases &amp; Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA"},{"name":"Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv L.","family":"Gaur","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Infectious Diseases &amp; Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Shu-Hwa","family":"Tien","sequence":"additional","affiliation":[{"name":"Occupational Health Clinic, Stanford Health Care, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Spangler","sequence":"additional","affiliation":[{"name":"Occupational Health Clinic, Stanford Health Care, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhukar","family":"Pai","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niaz","family":"Banaei","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Infectious Diseases &amp; Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA"},{"name":"Department of Medicine, Division of Infectious Diseases &amp; Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA"},{"name":"Clinical Microbiology Laboratory, Stanford Health Care, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.143180"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00034-13"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6673-7-6"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201305-0831OC"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu119"},{"key":"e_1_3_3_7_2","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1164\/rccm.201302-0365OC","article-title":"Interferon-gamma release assays and tuberculin skin testing for diagnosis of latent tuberculosis infection in healthcare workers in the United States","volume":"189","author":"Dorman SE","year":"2014","unstructured":"Dorman SE Belknap R Graviss EA Reves R Schluger N Weinfurter P Wang Y Cronin W Hirsch-Moverman Y Teeter LD Parker M Garrett DO Daley CL . 2014. 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