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Tuberculin skin test. How to optimise?
1Assistente Hospitalar de Pneumologia.
The tests used in the diagnosis of tuberculosis latent infection, the tuberculin skin test (TST) and the interferon -gamma assays (IGRA), identify the existence of an adaptive immune response towards mycobacterial antigens. Considering the limitations of the two tests, the best solution is to take advantage of the best characteristics of each one. Most of the authors agree to the use of the two tests, using the IGRAS in the confirmation of a positive TST (because of its higher specificity). The operative characteristics of TST depend on the prevalence of the illness in the community and the aim of its use (its operative characteristics are higher when used in the tracing scope or as a diagnostic test). To interpret correctly a TST, the physician must know the epidemiology of tuberculosis in the community and correctly define the indications for its use.
The tests used in the diagnosis of tuberculosis latent infection, the tuberculin skin test (TST) and the interferon -gamma assays (IGRA), identify the existence of an adaptive immune response towards mycobacterial antigens. Considering the limitations of the two tests, the best solution is to take advantage of the best characteristics of each one. Most of the authors agree to the use of the two tests, using the IGRAS in the confirmation of a positive TST (because of its higher specificity). The operative characteristics of TST depend on the prevalence of the illness in the community and the aim of its use (its operative characteristics are higher when used in the tracing scope or as a diagnostic test). To interpret correctly a TST, the physician must know the epidemiology of tuberculosis in the community and correctly define the indications for its use.
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