Clinical Utility of Interferon Gamma Assay in the Diagnosis of Tuberculosis

Madariaga, Miguel G.; Jalali, Ziba; Swindells, Susan

doi:10.3122/jabfm.2007.06.070109

Cited by 43 publications

(24 citation statements)

References 42 publications

(45 reference statements)

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“…Screening for LTBI with the IGRA test may turn out to be extremely useful in this situation [10], as well as in patients with HIV infection with CD4 T cell counts greater than 250/mm 3 [17]. Infections by other mycobacteria such as M. kansasii, M. szulgai and M. marinum could also lead to positive results [18].…”

Section: Discussionmentioning

confidence: 99%

Utility of an interferon-gamma release assay as a potential diagnostic aid for active pulmonary tuberculosis

Taki-Eddin

Monem

2011

J Infect Dev Ctries

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Introduction: Sensitivity, specificity, early confirmation and obtaining an optimal specimen are challenging problems in active tuberculosis (TB) diagnosis. Interferon-gamma release assay (IGRA) is a good indicator for latent TB but can it be useful as a diagnostic tool for active TB? This study was designed to address these challenges and assess the potential of IGRA as a diagnostic indicator of active pulmonary TB by comparing it with other MT diagnostic conventional methods and molecular methods. Methodology: The study was conducted on 91 patients with suspicion of pulmonary active TB. QuantiFERON-TB-Gold In-Tube, a commercial IFN-gamma assay, was compared with Ziehl Neelsen (ZN) smear, Lowenstein Jensen's (LJ) egg-based culture, and real-time polymerase chain reaction. The final clinical diagnosis was the standard comparator of the study. Results: Active pulmonary TB was confirmed in 48/91 (52.7%) patients. Sensitivity, specificity, positive predicted value (PPV), and negative predicted value (NPV) were 72.9%, 100%, 100%, 76.78% for ZN smear, 77.1%, 97.67%, 97.36%, 79.24% for LJ culture, 89.9%, 67.4%, 75.4%, 85.3% for IGRA, and 66.6%, 95.3%, 94.1%, 71.9% for real-time PCR, respectively. Conclusion: Albeit confounding in the case of latent TB infected patients presenting with non-TB pulmonary disease, IGRA was more sensitive than the other conventional and molecular methods, so it may improve diagnostic accuracy when used in combination with other standard methods. High NPV of IGRA for the diagnosis of active TB proposed an additional role of this test to exclude the infection with active TB.

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Section: Discussionmentioning

confidence: 99%

Utility of an interferon-gamma release assay as a potential diagnostic aid for active pulmonary tuberculosis

Taki-Eddin

Monem

2011

J Infect Dev Ctries

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“…The negative predictive value for M. tuberculosis infection is >95 % for both TST and IGRA negative results (23,24). This suggests that LTBI and active TB can be excluded with a high degree of certainty in immunocompetent individuals, if both tests are performed and both have negative results (25). In immunocompromised individuals, however, this prediction is very limited (8,23,24 …”

Section: Predictive Value Of Igra In the Development Of Active Diseasementioning

confidence: 95%

The Role of Interferon-gamma Release Assay in Tuberculosis Control

Savičević

Katalinić-Janković

Mise

et al. 2012

Archives of Industrial Hygiene and Toxicology

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The Role of Interferon-gamma Release Assay in Tuberculosis ControlTuberculosis is still one of the major global public health threats. Countries with low incidence must focus on exhausting the reservoir of future cases by preventing reactivation. Therefore, it is important to identify and effectively treat those individuals who have latent tuberculosis infection and who may develop active disease. The tuberculin skin test has been the standard for detection of immune response against M. tuberculosis since the beginning of the 20th century. The new millennium has brought advancement in the diagnosis of latent tuberculosis infection. The name of the new blood test is interferon-gamma release assay (IGRA). Croatia is a middle-incidence country with a long decreasing trend and developed tuberculosis control. To reach low incidence and finally eliminate tuberculosis, its tuberculosis programme needs a more aggressive approach that would include intensive contact investigation and treatment of persons with latent tuberculosis infection. This article discusses the current uses of IGRA and its role in tuberculosis control.

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“…On the other hand, the cross reactivity of TST with BCG and other NTMs (non-tuberculosis mycobacteria) makes it harder to interpret the results due to the diminishing specificity of the test (25). Nevertheless, TST is still considered an easy and inexpensive screening test with no laboratory equipment needed for clear definitions, making it available worldwide (26).…”

Section: Diagnostic Tools For Latent Tbmentioning

confidence: 99%

How Should We Manage Latent Tuberculosis Infection in Patients Receiving Anti-TNF-α Drugs: Literature Review

Naderi

Sheybani

Pajand

2016

Iran Red Crescent Med J

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Context: The introduction of new drugs that specifically antagonize tumor necrosis factor alpha (anti-TNF-α) has provided an effective treatment in a wide variety of autoimmune diseases. Nevertheless, the possibility of the reactivation of latent TB (Tuberculosis) infection (LTBI) among these patients is a considerable challenge. The aim of this paper is to evaluate LTBI diagnostic tools in patients who are candidates for anti-TNF-α therapy emphasizing how to manage these patients. Evidence Acquisition: A systematic web-based search was conducted in MEDLINE, Cochrane Library Database, and UpToDate ® resources using the key words "anti-TNF-α" and "latent tuberculosis" up to March 2015. Two reviewers extracted and summarized the data and suggested protocols for the diagnosis and management of LTBI in patients receiving TNF-α inhibitors. Results: There were somewhat different approaches proposed by various researchers regarding the subject. While no recommendation was found to be unique to include all patients in all situations, the data emphasize the importance of ruling out TB infection before deciding to start an anti-TNF-α drug.Conclusions: Special high-risk groups, including patients with LTBI, should be treated before receiving TNF-α inhibitors. The tuberculin skin test (TST) is a somewhat cost-effective test for the diagnosis of LTBI. However, its usefulness with respect to false results should be re-evaluated in this situation.

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Clinical Utility of Interferon Gamma Assay in the Diagnosis of Tuberculosis

Cited by 43 publications

References 42 publications

Utility of an interferon-gamma release assay as a potential diagnostic aid for active pulmonary tuberculosis

Utility of an interferon-gamma release assay as a potential diagnostic aid for active pulmonary tuberculosis

The Role of Interferon-gamma Release Assay in Tuberculosis Control

How Should We Manage Latent Tuberculosis Infection in Patients Receiving Anti-TNF-α Drugs: Literature Review

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