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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Gamma interferon release assays for detection of Mycobacterium tuberculosis infection
Clinical Microbiology Reviews, Volume 27, No. 1, Year 2014
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Description
Identification and treatment of latent tuberculosis infection (LTBI) can substantially reduce the risk of developing active disease. However, there is no diagnostic gold standard for LTBI. Two tests are available for identification of LTBI: the tuberculin skin test (TST) and the gamma interferon (IFN-γ) release assay (IGRA). Evidence suggests that both TST and IGRA are acceptable but imperfect tests. They represent indirect markers of Mycobacterium tuberculosis exposure and indicate a cellular immune response to M. tuberculosis. Neither test can accurately differentiate between LTBI and active TB, distinguish reactivation from reinfection, or resolve the various stages within the spectrum of M. tuberculosis infection. Both TST and IGRA have reduced sensitivity in immunocompromised patients and have low predictive value for progression to active TB. To maximize the positive predictive value of existing tests, LTBI screening should be reserved for those who are at sufficiently high risk of progressing to disease. Such high-risk individuals may be identifiable by using multivariable risk prediction models that incorporate test results with risk factors and using serial testing to resolve underlying phenotypes. In the longer term, basic research is necessary to identify highly predictive biomarkers. © 2014, American Society for Microbiology. All Rights Reserved.
Authors & Co-Authors
Pai, Madhukar
Canada, Montreal
Mcgill Faculty of Medicine and Health Sciences
Denkinger, Claudia Maria
Canada, Montreal
Mcgill Faculty of Medicine and Health Sciences
United States, Boston
Beth Israel Deaconess Medical Center
Kik, Sandra V.
Canada, Montreal
Mcgill Faculty of Medicine and Health Sciences
Rangaka, Molebogeng Xheeda
South Africa, Cape Town
University of Cape Town
Zwerling, Alice Anne
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Oxlade, Olivia
United States, Boston
Harvard T.h. Chan School of Public Health
Metcalfe, John Z.
United States, San Francisco
University of California, San Francisco
Cattamanchi, Adithya
United States, San Francisco
University of California, San Francisco
Dowdy, David W.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Dheda, Keertan U.J.
South Africa, Cape Town
University of Cape Town Lung Institute
Banaei, Niaz
United States, Stanford
Stanford University School of Medicine
Statistics
Citations: 688
Authors: 11
Affiliations: 8
Identifiers
Doi:
10.1128/CMR.00034-13
ISSN:
08938512
e-ISSN:
10986618
Research Areas
Infectious Diseases