4. BE PREPARED FOR A NEW IGRA IN 2018
Replacement of Quantiferon (QFT) - In Tube Assay with QFT-Plus Assay in the United States
As of October, 2017, the newer generation QFT-Plus assay was launched in the U.S., after having been implemented in Europe in 2016 and adopted by countries in the Middle East, Africa, Asian, and Latin America. It is anticipated that most U.S. laboratories will transition to the new QFT-Plus assay in 2018, as the QFT-In Tube assay will not be available in the U.S. after June 2018.
The QFT Plus assay is very similar to the QFT-In Tube assay which measures the interferon gamma production by CD4 cells after exposure to TB antigens. The QFT Plus assay includes an additional tube containing TB antigens that allows the measurement of interferon gamma release by CD8 cells after exposure to TB antigens. The information about CD8 cell activity may be helpful, as CD8 cells contribute to the immune response to active TB and new infection, and function in young children and individuals living with HIV. More information on the QFT Plus, including guidance on how to interpret the test may be accessed here. Questions regarding interpretation of the QFT Plus assay may be directed to the medical consultation at the TBCP at 213-745-0800.
Reminder: Testing for TB infection now a preventive care benefit under the Affordable Care Act in 2018
The USPSTF issued a recommendation that all adults at increased risk for TB be screened for TB infection. As mentioned in the May Rx for Prevention article, diagnostic testing for TB infection is now (effective January 2018) included as part of the preventive care benefit for adults and children as part of implementation of the Affordable Care Act. This means that Californians with health insurance who are at risk for TB infection will not have additional out of pocket costs for TB testing, thus eliminating one additional barrier to accessing diagnosis and treatment of TB infection.10 In LA County, uninsured patients at risk for TB infection can be referred to Public Health Centers and low cost clinics.