Comparison of performance in two diagnostic methods for tuberculosis infection

Higuchi, Kazue; Kawabe, Yojiro; Mitarai, Satoshi; Yoshiyama, Takashi; Harada, Nobuyuki; Mori, Toru

doi:10.1007/s00430-008-0102-5

Cited by 26 publications

(17 citation statements)

References 20 publications

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“…We excluded studies from analysis that either used criteria from the USA for scoring T-SPOT1.TB results [30], or that were performed in intermediate tuberculosis burden countries. In the latter, even individuals belonging to low-risk groups may have been exposed to unknown M. tuberculosis infection with a potentially higher risk of infection than that expected in low-burden countries [31][32][33]. Regarding the comparison of IGRAs with TST, one report [28] was excluded because the TST was not performed in all the enrolled subjects.…”

Section: Specificitymentioning

confidence: 99%

Interferon- release assays for the diagnosis of latent Mycobacterium tuberculosis infection: a systematic review and meta-analysis

Diel¹,

Goletti²,

Ferrara³

et al. 2010

European Respiratory Journal

482

315

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We conducted a systematic review and meta-analysis to compare the accuracy of the QuantiFERON-TB1 Gold In-Tube (QFT-G-IT) and the T-SPOT1.TB assays with the tuberculin skin test (TST) for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI).The Medline, Embase and Cochrane databases were explored for relevant articles in November 2009. Specificities, and negative (NPV) and positive (PPV) predictive values of interferon-c release assays (IGRAs) and the TST, and the exposure gradient influences on test results among bacille Calmette-Guérin (BCG) vaccinees were evaluated.Specificity of IGRAs varied 98-100%. In immunocompetent adults, NPV for progression to tuberculosis within 2 yrs were 97.8% for T-SPOT1.TB and 99.8% for QFT-G-IT. When test performance of an immunodiagnostic test was not restricted to prior positivity of another test, progression rates to tuberculosis among IGRA-positive individuals followed for 19-24 months varied 8-15%, exceeding those reported for the TST (2-3%). In multivariate analyses, the odd ratios for TST positivity following BCG vaccination varied 3-25, whereas IGRA results remained uninfluenced and IGRA positivity was clearly associated with exposure to contagious tuberculosis cases.IGRAs may have a relative advantage over the TST in detecting LTBI and allow the exclusion of M. tuberculosis infection with higher reliability.

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Section: Specificitymentioning

confidence: 99%

Interferon- release assays for the diagnosis of latent Mycobacterium tuberculosis infection: a systematic review and meta-analysis

Diel¹,

Goletti²,

Ferrara³

et al. 2010

European Respiratory Journal

482

315

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“…In countries with a low TB incidence, the ESAT-6-induced IFN-␥ response was found to be sensitive and specific in diagnosing latent TB infection (18,31), and exposed contacts with high levels of IFN-␥ production have a greater possibility of developing active TB than those with lower IFN-␥ levels (30). However, in high-TB-incidence countries, different data were obtained.…”

Section: Discussionmentioning

confidence: 99%

Variation in Gamma Interferon Responses to Different Infecting Strains of Mycobacterium tuberculosis in Acid-Fast Bacillus Smear-Positive Patients and Household Contacts in Antananarivo, Madagascar

Rakotosamimanana

Raharimanga

Andriamandimby

et al. 2010

Clin Vaccine Immunol

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The majority of healthy individuals exposed to Mycobacterium tuberculosis will not develop tuberculosis (TB), though many may become latently infected. More precise measurement of the human immune response to M. tuberculosis infection may help us understand this difference and potentially identify those subjects most at risk of developing active disease. Gamma interferon (IFN-␥) production has been widely used as a proxy marker to study infection and to examine the human immune response to specific M. tuberculosis antigens. It has been suggested that genetically distinct M. tuberculosis strains may invoke different immune responses, although how these differences influence the immune responses and clinical outcome in human tuberculosis is still poorly understood. We therefore evaluated the antigen-specific IFN-␥ production responses in peripheral blood mononuclear cells from two cohorts of subjects recruited in Antananarivo Tuberculosis (TB), caused by Mycobacterium tuberculosis, is a major cause of global morbidity and mortality throughout the world. It is estimated that there are in excess of new 8 million cases of TB each year, and this represents just the tip of the iceberg. Infection with M. tuberculosis leads to clinically active TB in about 5 to 10% of exposed individuals. A much higher proportion of exposed individuals apparently become latently infected, and these individuals may remain noninfectious and symptom free for years. Approximately one-third of the world population is thought to be latently infected with M. tuberculosis. However, under some circumstances (in about 5% of the latently infected people), the host immune response is perturbed and latent M. tuberculosis infection may develop into clinically active TB (52). This process is most prominent in individuals coinfected with human immunodeficiency virus (HIV), but it can also occur with impairment of the immune system associated with old age, malnutrition, anti-inflammatory drug treatment, etc. Reactivation of latent disease is thought to contribute roughly half of all TB cases, and thus, understanding the factors controlling the development of acute primary TB or latent infection is crucial to TB control (64).Gamma interferon (IFN-␥) production has been widely used to study infection and to examine the human immune response to specific M. tuberculosis antigens. The 6-kDa early secreted antigenic target (ESAT-6) antigen, encoded by genes located within region of difference 1 (RD1) of the M. tuberculosis genome, is much more specific for M. tuberculosis than purified protein derivative (PPD), as these genes were deleted from M. bovis in the development of BCG substrains or are not found in most environmental mycobacteria (29,53). Some studies showed that the level of IFN-␥ release in response to ESAT-6 could identify TB contacts at risk of developing active disease after recent infection (3,18,30). CFP7 or TB10.4 is an immunodominant antigen recognized by TB patients and M. bovis BCG-vaccinated subjects, while ESAT-6 is specific to TB pa-

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“…The Tokyo group identified higher sensitivity and lower specificity of T-SPOT.TB versus QFT-G in the diagnosis of LTBI in Japanese subjects [39].…”

Section: Chronic Patients Undergoing Haemodialysismentioning

confidence: 95%

Steps forward in LRTI and tuberculosis: update from the ERS Respiratory Infections Assembly

Blasi

Cosentini

Migliori

et al. 2009

European Respiratory Journal

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Lower respiratory tract infections (LRTIs) and tuberculosis are among the leading reasons for seeking medical care.In the present report, the most recent advances in the fields of clinical research and basic science of LRTIs and tuberculosis are presented through analysis of some of the best abstracts presented at the 18th European Respiratory Society Annual Congress in Berlin.The role of viruses in chronic obstructive pulmonary disease exacerbations and the importance of new biomarkers in the diagnosis of bacterial infections in LRTI are discussed.New tools for the diagnosis of latent and active tuberculosis in special subgroups of patients (children, immunocompromised individuals, etc.), and the new epidemiological threat of multidrug-resistant and extensively drug-resistant tuberculosis cases is analysed.

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Comparison of performance in two diagnostic methods for tuberculosis infection

Cited by 26 publications

References 20 publications

Interferon- release assays for the diagnosis of latent Mycobacterium tuberculosis infection: a systematic review and meta-analysis

Interferon- release assays for the diagnosis of latent Mycobacterium tuberculosis infection: a systematic review and meta-analysis

Variation in Gamma Interferon Responses to Different Infecting Strains of Mycobacterium tuberculosis in Acid-Fast Bacillus Smear-Positive Patients and Household Contacts in Antananarivo, Madagascar

Steps forward in LRTI and tuberculosis: update from the ERS Respiratory Infections Assembly

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