Interferon-γ release assays versus tuberculin skin test for targeting people for tuberculosis preventive treatment: An evidence-based review - 06/03/13
Corresponding author. Department of Infectious Diseases, Bellvitge University Hospital, Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain. Tel.: +34 932 607 625; fax: +34 932 607 637.Summary |
Objectives |
To assess whether Interferon-γ release assays (IGRAs) reduce the number of people considered for tuberculosis (TB) preventive treatment without increasing subsequent active disease.
Methods |
Longitudinal studies with both tuberculin skin test (TST) and IGRAs were identified through a PubMed search. Reductions in diagnosis of TB infection and increases in incident TB in people considered not infected, using IGRAs either instead of TST or as a confirmatory test (two-step approach), were assessed.
Results |
In comparison with TST alone, the pooled reductions in diagnosis of TB infection obtained with IGRAs were 16.7% and 5.8% at 5 and 10 mm cut-offs respectively, and 24.5% and 12.4% at 5 and 10 mm respectively with the two-step approach. Compared with TST alone, incident TB among people considered not infected increased with the two-step approach (0.94% with T-SPOT®.TB and 1.1% with QuantiFERON®-TB Gold In-Tube) in one of seven studies in high-income countries. In middle- and low-income countries, two of four studies presented increases (0.08 and 0.03 per 100 patient-years respectively) with the two-step approach.
Conclusions |
In high-income countries, the use of IGRAs, either instead of TST or as confirmatory test reduces the number of people considered for preventive treatment, without a significant risk of subsequent active disease.
Le texte complet de cet article est disponible en PDF.Keywords : Tuberculosis, Latent tuberculosis infection, Tuberculin skin test, Interferon-gamma release assays, QuantiFERON-TB Gold in-tube, T-SPOT.TB, Systematic review
Plan
Vol 66 - N° 4
P. 381-387 - avril 2013 Retour au numéro
Article précédent
- Tuberculosis skin test, but not interferon-γ-releasing assays is affected by BCG vaccination in HIV patients
- T. Wolf, U. Goetsch, G. Oremek, M. Bickel, P. Khaykin, A. Haberl, O. Bellinger, R. Gottschalk, H.R. Brodt, C. Stephan
- Could concentrating single sputum improve the performance of smear microscopy in detecting TB among HIV patients?
- Ramachandran Vignesh, Chinnambedu R. Swathirajan, Suniti Solomon, Greer Waldrop, Sunil S. Solomon, Chandrasekaran Ezhilarasi, Pachamuthu Balakrishnan
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?