Demographic and clinical correlates of discordant QuantiFERON TB Gold tuberculosis screening results in a low-incidence setting

Reliable interpretation of interferon-γ release assays (IGRAs) is critical for the diagnosis and management of latent tuberculosis infection (LTBI). However, variability in test performance during serial or confirmatory testing complicates clinical decision-making and may result in unnecessary treatment. Our study demonstrates that demographic factors, clinical comorbidities, and testing intervals contribute to discordant QuantiFERON-TB Gold Plus results. These findings underscore the need to integrate epidemiologic risk, pre-test probability of <i>Mycobacterium tuberculosis</i> complex exposure, clinical history, and repeat testing when appropriate before initiating LTBI therapy. Improved understanding of IGRA variability can strengthen both patient care and research applications, including tuberculosis vaccine and protective biomarker studies.