Latent Tuberculosis Infection
Conditions
Keywords
Tuberculosis, Latent tuberculosis infection, Tuberculin skin test, Interferon-gamma release assays, Contact-tracing study
Brief summary
Hypothesis: a combined strategy of tuberculin skin test (TST) followed by QuantiFERON-TB Gold In-Tube (QFT-IT) to confirm positivity (tuberculosis infection,in contact-tracing study will allow avoiding unnecessary preventive treatment without increasing rates of tuberculosis cases among contacts screened. Aim of the study: to compare a combined strategy of the TST and the QFT-IT with TST alone for the diagnosis of tuberculosis infection and for therapeutic decision in contact tracing study. Design and setting: Prospective, multicentre, comparative study in 12 hospitals in Spain. Study population: 870 subjects, household contacts of patients with culture positive pulmonary and/or laryngeal tuberculosis will be randomized to one of two strategies: Arm A (standard practice), in which treatment decisions will be based on the TST result, and Arm B (experimental), in which treatment decisions will be based on the QFT result. Interventions: participants in arm A will undergo TST; participants in arm B will undergo TST, and, in case of a positive result, QFT-IT as well. Participants with positive TST (arm A) and positive QFT-IT (arm B) will be diagnosed with tuberculosis infection and will be treated with isoniazid for 6 months. All participants will be followed for two years. End-points of evaluation: development of tuberculosis and proportion of subjects for whom treatment is prescribed in each arm.
Interventions
If TST positive: participant will be treated with Isoniazid 300 mg/d, for 6 months.
If QFT-IT positive, Isoniazid 300 mg/d, for 6 months.
Sponsors
Study design
Eligibility
Inclusion criteria
* Age ≥18 years. * Close contact of a pulmonary and/or laryngeal tuberculosis case. * Written informed consent.
Exclusion criteria
* HIV infection. * Immunosuppression other than HIV, such as decompensated liver disease, chronic renal failure, corticosteroids treatment, malignancy under chemotherapy therapy. * Prior tuberculosis or positive TST. * Strain resistant to Isoniazid (index case).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Development of tuberculosis. | Assessment of primary end-point: 24 months after randomization. |
Secondary
| Measure | Time frame |
|---|---|
| Prescription of treatment. | The day 0 (visit 2) after randomization. |
Countries
Spain