{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:53:05Z","timestamp":1793746385330,"version":"4.6.1"},"reference-count":43,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/501100013263","name":"Norwegian Health Association","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100013263","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Targeted testing and treatment of latent TB infection (LTBI) are priorities on the global health agenda, but LTBI management remains challenging. We aimed to evaluate the prognostic value of the QuantiFERON TB-Gold (QFT) test for incident TB, focusing on the interferon (IFN)-\u03b3 level, when applied in routine practice in a low TB incidence setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this large population-based prospective cohort, we linked QFT results in Norway (1 January 2009\u201330 June 2014) with national registry data (Norwegian Surveillance System for Infectious Diseases, Norwegian Prescription Database, Norwegian Patient Registry and Statistics Norway) to assess the prognostic value of QFT for incident TB. Participants were followed until 30 June 2016. We used restricted cubic splines to model non-linear relationships between IFN-\u03b3 levels and TB, and applied these findings to a competing risk model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prospective analyses included 50 389 QFT results from 44 875 individuals, of whom 257 developed TB. Overall, 22% (n=9878) of QFT results were positive. TB risk increased with the IFN-\u03b3 level until a plateau level, above which further increase was not associated with additional prognostic information. The HRs for TB were 8.8 (95% CI 4.7 to 16.5), 19.2 (95% CI 11.6 to 31.6) and 31.3 (95% CI 19.8 to 49.5) times higher with IFN-\u03b3 levels of 0.35 to &lt;1.00, 1.00 to &lt;4.00 and &gt;4.00 IU\/mL, respectively, compared with negative tests (&lt;0.35 IU\/mL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Consistently, QFT demonstrates increased risk of incident TB with rising IFN-\u03b3 concentrations, indicating that IFN-\u03b3 levels may be used to guide targeted treatment of LTBI.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thoraxjnl-2017-211147","type":"journal-article","created":{"date-parts":[[2018,4,5]],"date-time":"2018-04-05T22:46:38Z","timestamp":1522968398000},"page":"652-661","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":71,"title":["Stratification by interferon-\u03b3 release assay level predicts risk of incident TB"],"prefix":"10.1136","volume":"73","author":[{"given":"Brita Askeland","family":"Winje","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Syre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dag Harald","family":"Skutlaberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Oftung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Torunn","family":"Mengshoel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hege Salvesen","family":"Blix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne Broch","family":"Brants\u00e6ter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen Kristine","family":"Holter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Handal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar Skov","family":"Simonsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Egil","family":"Afset","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marte","family":"Bakken Kran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,4,5]]},"reference":[{"key":"2020050723435324000_73.7.652.1","unstructured":"WHO. Guidelines for the management of latent tuberculosis infection. Geneva, 2014. http:\/\/www.who.int\/tb\/publications\/ltbi_document_page\/en\/ (cited 28 Oct 2014)."},{"key":"2020050723435324000_73.7.652.2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00034-13"},{"key":"2020050723435324000_73.7.652.3","first-page":"1352","article-title":"Preventive chemotherapy Where has it got us? Where to go next?","volume":"12","author":"Landry","year":"2008","journal-title":"Int J Tuberc Lung Dis"},{"key":"2020050723435324000_73.7.652.4","unstructured":"Arnesen TM , Heldal E , Mengshoel AT , et al . Tuberkulose i Norge 2015 - med behandlingsresultater for 2014. Oslo: Folkehelseinstituttet, 2016."},{"key":"2020050723435324000_73.7.652.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02742-2"},{"key":"2020050723435324000_73.7.652.6","unstructured":"International Classification of Diseases 10th revision: Directorate of Health. 2017 https:\/\/finnkode.ehelse.no\/#icd10\/0\/0\/0\/-1 (accessed 01 Jun 2017)."},{"key":"2020050723435324000_73.7.652.7","unstructured":"WHO Collaborating Centre for Drug Statistics Methodolgy ATC classification index with DDDs Oslo2016. 2015 https:\/\/www.whocc.no\/atc_ddd_index\/ (accessed 01 Jun 2017)."},{"key":"2020050723435324000_73.7.652.8","unstructured":"Folkehelseinstituttet. Guidelines for prevention and control of tuberculosis. Oslo: Norwegian Institute of Public Health, 2016. https:\/\/www.fhi.no\/nettpub\/tuberkuloseveilederen\/ (accessed 23 Jun 2017)."},{"key":"2020050723435324000_73.7.652.9","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-208228"},{"key":"2020050723435324000_73.7.652.10","unstructured":"StataCorp. Stata statistical software: release 14: College Station, TX: StataCorp LP, 2015."},{"key":"2020050723435324000_73.7.652.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-2456(00)00134-3"},{"key":"2020050723435324000_73.7.652.12","unstructured":"WHO. Global Tuberculosis Report.Geneva:2016. http:\/\/www.who.int\/tb\/publications\/global_report\/en\/ (accessed 01 Jun 2017)."},{"key":"2020050723435324000_73.7.652.13","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201006-0974OC"},{"key":"2020050723435324000_73.7.652.14","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.2.704-706.2002"},{"key":"2020050723435324000_73.7.652.15","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201502-0232OC"},{"key":"2020050723435324000_73.7.652.16","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200604-472OC"},{"key":"2020050723435324000_73.7.652.17","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200402-179OC"},{"key":"2020050723435324000_73.7.652.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2008.02.011"},{"key":"2020050723435324000_73.7.652.19","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201405-188OC"},{"key":"2020050723435324000_73.7.652.20","first-page":"1","article-title":"Serial testing with interferon-y release assay in German healthcare workers","volume":"5","author":"Schablon","year":"2010","journal-title":"GMS Krankenhhyg Interdiszip"},{"key":"2020050723435324000_73.7.652.21","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268809002751"},{"key":"2020050723435324000_73.7.652.22","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2236-c1"},{"key":"2020050723435324000_73.7.652.23","first-page":"28","article-title":"Controlled chemoprophylaxis trials in tuberculosis. A general review","volume":"26","author":"Ferebee","year":"1970","journal-title":"Bibl Tuberc"},{"key":"2020050723435324000_73.7.652.24","first-page":"1014","article-title":"Tuberculin skin test size and risk of tuberculosis development: a large population-based study in contacts","volume":"11","author":"Mor\u00e1n-Mendoza","year":"2007","journal-title":"Int J Tuberc Lung Dis"},{"key":"2020050723435324000_73.7.652.25","doi-asserted-by":"crossref","unstructured":"Pai M , Behr M . Latent Mycobacterium tuberculosis Infection and Interferon-Gamma Release Assays. 2016;4.","DOI":"10.1128\/microbiolspec.TBTB2-0023-2016"},{"key":"2020050723435324000_73.7.652.26","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00058911"},{"key":"2020050723435324000_73.7.652.27","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70210-9"},{"key":"2020050723435324000_73.7.652.28","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01047-2015"},{"key":"2020050723435324000_73.7.652.29","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-3157"},{"key":"2020050723435324000_73.7.652.30","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201406-1159OC"},{"key":"2020050723435324000_73.7.652.31","doi-asserted-by":"publisher","DOI":"10.1086\/597351"},{"key":"2020050723435324000_73.7.652.32","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-10-670"},{"key":"2020050723435324000_73.7.652.33","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00510-2016"},{"key":"2020050723435324000_73.7.652.34","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02033-2015"},{"key":"2020050723435324000_73.7.652.35","doi-asserted-by":"publisher","DOI":"10.1002\/eji.201243262"},{"key":"2020050723435324000_73.7.652.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2014.06.009"},{"key":"2020050723435324000_73.7.652.37","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201107-1355OC"},{"key":"2020050723435324000_73.7.652.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2012.11.023"},{"key":"2020050723435324000_73.7.652.39","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01084-2016"},{"key":"2020050723435324000_73.7.652.40","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00151-8"},{"key":"2020050723435324000_73.7.652.41","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S2213-2600(16)30419-2","article-title":"From latent to patent: rethinking prediction of tuberculosis","volume":"5","author":"Cobelens","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2020050723435324000_73.7.652.42","unstructured":"Rothman K . Epidemiology, an introduction. New York, NY 10016: Oxford University Press, 2002."},{"key":"2020050723435324000_73.7.652.43","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00115110"}],"container-title":["Thorax"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/thoraxjnl-2017-211147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T06:05:35Z","timestamp":1601100335000},"score":1,"resource":{"primary":{"URL":"https:\/\/thorax.bmj.com\/lookup\/doi\/10.1136\/thoraxjnl-2017-211147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,5]]},"references-count":43,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2018,6,13]]},"published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1136\/thoraxjnl-2017-211147"],"URL":"https:\/\/doi.org\/10.1136\/thoraxjnl-2017-211147","relation":{},"ISSN":["0040-6376","1468-3296"],"issn-type":[{"value":"0040-6376","type":"print"},{"value":"1468-3296","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,5]]}}}