According to the World Health Organization (WHO), health services need to be actively engaged for an effective and rapid response to COVID-19 while ensuring that TB and other essential health services are maintained1.

TB blood testing can provide critical insight into the elevated risks associated with COVID-19

  • People ill with COVID-19 and TB show similar symptoms such as cough, fever, and difficulty breathing1
  • While experience with COVID-19 infection in TB patients remains limited, it is anticipated that people ill with both TB and COVID-19 may have poorer treatment outcomes, especially if TB treatment is interrupted1
  • The sooner you can detect latent TB in your patients, the earlier you can start treatment, potentially lowering their risk factors for an unfavorable outcome from a COVID-19 infection

IGRAs are preferred over tuberculin skin tests (TST) for many patient types and situations.

The CDC and other medical organizations prefer interferon-gamma release assays (IGRAs) for certain patient populations:
  • Groups with poor rates of return for TST reading2
  • Individuals who have received the Bacille Calmette-Guérin (BCG) vaccination
  • Individuals taking the US Citizenship and Immigration Services (USCIS) immigration exams3

With a single visit and a highly accurate, objective result unaffected by the BCG vaccine, IGRAs are preferred over tuberculin skin tests.

Today’s TB blood tests—T-SPOT®.TB and QuantiFERON®-TB Gold Plus: objective resulting
  • Results available from a single patient visit
  • Option for electronic results (reported straight to EMR)
  • T-SPOT®.TB—estimated sensitivity: 95.6%; estimated specificity: 97.1%
  • QuantiFERON®-TB Gold Plus—estimated sensitivity: 94.09%; estimated specificity: 97.27%
  • Flexible collection options: 1-tube or 4-tubes

Learn more about QuantiFERON®-TB Gold Plus.

Learn more about T-SPOT®.TB.

Century-old Mantoux tuberculin skin test: subjective reading/interpretation

The photograph was originally published in the Valley Echo and has been reproduced with the permission of the Lung Association of Saskatchewan.

  • Requires 2 patient visits and manual results
  • Sensitivity 95%–98% in patients with proven active tuberculosis, specificity as low as 59% in BCG-vaccinated patients (high false positives)

Immunocompromised patients have an increased risk for TB

Those with compromised immune systems face a higher risk of contracting TB and a higher risk of latent tuberculosis infection (LTBI) becoming active.4 A TB infection can also increase the progression of chronic diseases and conditions.5 Plus, creating a treatment plan for TB for your immunocompromised patients can become complicated by cumulative toxicities and drug interactions.6

Quest Diagnostics T-SPOT®.TB test is a unique, single-visit blood test for tuberculosis (TB) that offers the opportunity to detect latent TB before it activates. The test is effective with immunocompromised and BCG-vaccinated patient populations and is the only IGRA without a warning or limitation for screening immunocompromised individuals.3

Learn more about how the T-SPOT®.TB test can mitigate the risk that low T cell count will impact patient results.

Choosing the better way to test for TB is more important than ever as we face the implications of COVID-19

  • 1 visit, 1 tube: both T-SPOT®.TB and QuantiFERON®-TB Gold Plus only require the patient to come into the office 1 time instead of 2 times (and use 1 tube instead of 2 tubes), which reduces office visits and minimizes potential exposure to COVID-19
  • More than 2,250 Quest Patient Service Centers are implementing enhanced safety measures with our Peace of Mind program that includes more frequent cleaning, social distancing, and required face masks for both patients and employees.
When you’re ready to make the switch, only Quest Diagnostics offers a choice of tuberculosis blood tests: T-SPOT®.TB and QuantiFERON®-TB Gold Plus (QFT-Plus), both of which have a single-tube collection option. Get in touch with us today.
Test name Test code CPT codea
T-SPOT®.TB 37737 86481
QuantiFERON®-TB Gold Plus, 1 Tube 36970 86480
QuantiFERON®-TB Gold Plus, 4 Tubes, Draw Site Incubated 36971 86480

a The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Learn more about QuantiFERON-TB Gold Plus  
Learn more about T-SPOT.TB

Questions? Call 1.866.MYQUEST (1.866.697.8378).

Quest Diagnostics is committed to providing the most advanced TB screening available, in accordance with clinical guidelines.

Tuberculosis screening guidelines have been updated to include modern TB infection testing methods, including interferon-gamma release assays or TB blood tests, to address the limitations of the tuberculin skin tests.

United States Preventive Services Task Force7

Grade B recommendation:

  • Screening for latent TB infection (LTBI) in populations at increased risk
    • Foreign-born adults from higher prevalence countries, regardless of age, duration in the US, or co-morbidities
    • Individuals in congregate settings
  • Ensures LTBI screening for at-risk adults is covered by most private health plans, Medicaid, and Medicare
American Thoracic Society, Infectious Diseases Society of America, and CDC8
  • IGRAs are preferred for patients > 5 years of age with low to intermediate risk of progression, regardless of BCG status or likelihood of returning8
  • IGRA or TST can be used without preference in individuals > 5 years of age with high risk of progression8
  • TST is preferred for children < 5 years of age, but IGRA is acceptable8
  • American Academy of Family Physicians (AAFP) endorses these guidelines9
American Academy of Pediatrics (AAP)10
  • Interferon-gamma release assays or tuberculin skin test can be used to detect TB infection among at-risk children > 2 years of age
  • IGRAs are preferred for children who are BCG-vaccinated or unlikely to return
  • Children with HIV infection should receive annual IGRA testing or TST
  • Risk assessment for TB should be performed at the first encounter and then annually
American College of Rheumatology (ACR)7
  • TB screening in all rheumatoid arthritis (RA) patients being considered for therapy with biological agents, regardless of the presence of risk factors for TB infection
  • IGRA is preferred over TST in the same patients listed in the CDC guidelines
  • IGRA can be performed as an initial test in all RA patients, in annual testing, and where TB exposure is likely
  • In immunosuppressed RA patients with risk of TB exposure, a repeat test can be considered 1–3 weeks after initial negative result
  • Annual TB screening in RA patients who live, travel, or work in environments where TB exposure is likely while continuing treatment with biologics

Get in touch with us

There are often a lot of questions when it comes to TB testing—more so today with the complications of the COVID-19 pandemic. Please complete the form below for a sales representative to contact you to discuss the benefits of IGRA blood testing, or to help you select the right test for your patients.

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T-SPOT®.TB and QuantiFERON®-TB Gold Plus are approved by the US FDA.
The T-SPOT®.TB test is an in vitro diagnostic test for the detection of effector T cells that respond to stimulation by Mycobacterium tuberculosis antigens ESAT-6 and CFP 10 by capturing interferon gamma (IFN-y) in the vicinity of T cells in human whole blood collected in sodium citrate or sodium or lithium heparin. It is intended for use as an aid in the diagnosis of M. tuberculosis infection. The T-SPOT®.TB test is an indirect test for M. tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography, and other medical and diagnostic evaluations. For more information, visit www.tspot.com.

QuantiFERON®-TB Gold Plus is approved by the FDA as an in vitro diagnostic aid for detection of Mycobacterium tuberculosis infection. It uses a peptide cocktail simulating ESAT-6 and CFP-10 proteins to stimulate cells in heparinized whole blood. Detection of IFN-y by ELISA is used to identify in vitro responses to these peptide antigens that are associated with M. tuberculosis infection. QuantiFERON®-TB Gold Plus is an indirect test for M. tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography, and other medical and diagnostic evaluations. Up-to-date licensing information and product-specific disclaimers can be found at www.QuantiFERON.com.

References

  1. World Health Organization (WHO). Q&A: Tuberculosis and COVID-19. May 11, 2020. Accessed July 17, 2020. https://www.who.int/news-room/q-a-detail/tuberculosis-and-the-covid-19-pandemic
  2. Centers for Disease Control and Prevention (CDC). BCG vaccine. Reviewed May 4, 2019. Accessed December 12, 2018. www.cdc.gov/tb/publications/factsheets/prevention/bcg.htm
  3. Oxford Immunotec. T-SPOT®.TB Package Insert PI-TB-US-V6. Abingdon, UK. May 2017.
  4. Centers for Disease Control and Prevention (CDC). Tuberculosis (TB). Reviewed December 31, 2018. Accessed January 9, 2020. https://www.cdc.gov/tb/default.htm
  5. World Health Organization (WHO). Guidelines on the management of latent tuberculosis infection. Recommendations. Published January 1, 1970. Accessed January 9, 2020. https://www.ncbi.nlm.nih.gov/books/ NBK293812/
  6. World Health Organization (WHO). Global tuberculosis report 2019. Released October 17, 2019. Accessed January 9, 2020. https://www.who.int/tb/publications/global_report/en/
  7. Centers for Disease Control and Prevention (CDC). Tuberculosis technical instructions for civil surgeons. Reviewed September 23, 2019. Accessed August 13, 2020. https://www.cdc.gov/immigrantrefugeehealth/exams/ti/civil/tuberculosis-civil-technical-instructions.html#:~:text=%20Tuberculosis%20Technical%20Instructions%20for%20Civil%20Surgeons%20,focus%20on%20risk%20factors%20for%20 tuberculosis...%20More%20
  8. Centers for Disease Control and Prevention. Latent tuberculosis infection: a guide for primary health care providers. Last reviewed July 20, 2020. Accessed August 14, 2020. www.cdc.gov/tb/publications/ltbi
  9. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Screening for latent tuberculosis infection in adults: US Preventive Services Task Force recommendation statement. JAMA. 2016;316(9):962-969. doi:10.1001/jama.2016.11046
  10. Mazurek, GH, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K. Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection—United States, 2010. MMWR Recomm Rep. 2010;59(RR-5):1–25