From the Guidelines
If you have a positive QuantiFERON Gold test result, you should be evaluated for TB disease before latent TB infection (LTBI) is diagnosed, and this evaluation should include a chest radiograph and possibly additional medical tests based on clinical judgment. This approach is recommended because a positive QuantiFERON Gold result indicates the presence of Mycobacterium tuberculosis infection, and it is crucial to differentiate between active TB disease and LTBI due to the different management strategies for each condition 1.
The next steps after a positive QuantiFERON Gold test result should include:
- A thorough medical evaluation to rule out active TB disease, which may involve a physical examination, chest radiography, and potentially sputum tests.
- HIV counseling, testing, and referral, as HIV infection can increase the risk of TB and the urgency for treating LTBI 1.
- If active TB is excluded, consideration for treatment of LTBI to prevent the progression to active TB disease.
It's essential to follow the guidelines for managing a positive QuantiFERON Gold test result, as outlined in the recommendations for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection 1, to ensure appropriate public health and medical interventions are implemented.
From the Research
Next Steps after a Positive QuantiFERON Gold Test Result
If you have a positive QuantiFERON Gold test result, it indicates that you have been infected with Mycobacterium tuberculosis, the bacteria that cause tuberculosis (TB). Here are the next steps you should consider:
- Consult a healthcare professional: It is essential to consult a healthcare professional, such as a doctor or a nurse practitioner, to discuss your test results and determine the best course of action 2, 3.
- Determine the presence of active TB: Your healthcare professional will perform a physical examination, take a complete medical history, and order additional tests, such as a chest X-ray and sputum tests, to determine if you have active TB or latent TB infection (LTBI) 4, 5.
- Treatment for LTBI: If you have LTBI, your healthcare professional may recommend treatment with isoniazid (INH) or other medications to prevent the development of active TB 2, 5.
- Monitoring and follow-up: After starting treatment, you will need to be monitored regularly to ensure that the treatment is effective and to check for any potential side effects 2, 5.
Important Considerations
- Risk factors: Certain risk factors, such as recent immigration from a TB-endemic country, previous TB disease, or exposure to someone with active TB, can increase your likelihood of having a positive QuantiFERON Gold test result 2, 3.
- Test limitations: The QuantiFERON Gold test is not perfect and may have false-positive or false-negative results. Your healthcare professional will consider your test results in conjunction with other factors, such as your medical history and physical examination, to make a diagnosis 4, 6.
- Newer versions of the test: There are newer versions of the QuantiFERON test, such as the QuantiFERON-TB Gold Plus, which may have improved sensitivity and specificity compared to the original test 4, 6.