Enhanced Tuberculosis Infection Treatment Outcomes after Implementation of QuantiFERON®-Gold Testing

Among 36,167 patients tested with QFT-G, 2,300 (6%) tested positive, 33,327 (93%) tested negative, and 540 (1%) had an indeterminate result. Among those who had a positive QFT-G test and deemed eligible, 985 (80%) initiated LTBI treatment and 490 (40%) completed treatment. Historically, among patients tested with TST, 7,073 (19%) tested positive (p<0.0001 compared to QFT-G); 3,182 (79%) of those eligible initiated LTBI treatment and 1,210 (30%) completed treatment (p<0.0001 compared to QFT-G).

QFT-G implementation increased the proportion of patients completing latent tuberculosis infection (LTBI) treatment. Additional studies are needed in more settings to determine whether using QFT-G leads to a sustained increase in treatment completion.

Below: From testing to treating LTBI in New York City Department of Health and Mental Hygiene chest clinics by QFT-G (2006–2008) or TST (2004–2006). (a). Flowchart representing the flow of patients from testing to treatment for LTBI in the utilization periods (QFT-G and TST).Complete Evaluation: evaluation by a physician and had a chest radiograph. Incomplete Evaluation: patients who were evaluated by a physician or had a chest radiograph but not both. LTBI Treatment Completion: 9 months of isoniazid or completion of an alternative regimen, per ATS/CDC and NYC DOHMH guidelines at that time. (b)Comparison of final LTBI test results, treatment initiation, and treatment outcomes between the utilization periods (QFT-G and TST). The bars represent (from left to right) the percentage of patients who tested positive for LTBI; of patients who tested positive, the percentage evaluated for LTBI treatment; of those evaluated, the percentage that had an indication for treatment; percentage of patients with treatment indication who initiated treatment for LTBI; percentage that completed treatment for LTBI among those who had an indication, and the percentage that completed treatment among all those with an indication for treatment who started treatment. [*] P<0.001, [**] P<0.0001

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By: Aldo Crossa, Jason Kessler, Tiffany G. Harris

New York City Department of Health and Mental Hygiene, New York, New York, United States of America

Jason Kessler

Mailman School of Public Health, Columbia University, New York, New York, United States of America