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Interferon-gamma release assay performance in pulmonary and extrapulmonary tuberculosis
Yun Feng1, Ni Diao, Lingyun Shao
1Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Plos One
|March 20, 2012
Summary
Interferon-gamma release assay (IGRA) effectively diagnoses active tuberculosis (TB) in pulmonary and extrapulmonary cases. Tuberculin skin test (TST) is unreliable for TB diagnosis in BCG-vaccinated individuals.
Area of Science:
- Immunology
- Infectious Diseases
- Diagnostics
Background:
- Tuberculosis (TB) diagnosis presents significant challenges.
- Accurate diagnostic tools are crucial for both pulmonary and extrapulmonary TB.
- Evaluating tests in BCG-vaccinated populations is essential due to potential cross-reactivity.
Purpose of the Study:
- To assess the performance of Interferon-Gamma Release Assay (IGRA), specifically T-SPOT.TB, for diagnosing active TB.
- To compare IGRA with the Tuberculin Skin Test (TST) in a BCG-vaccinated population.
- To determine the diagnostic utility of IGRA and TST for pulmonary and extrapulmonary TB.
Main Methods:
- Recruited 226 active TB suspects for T-SPOT.TB testing.
- Conducted simultaneous TST with 5TU or 1TU purified protein derivative (PPD) on subsets of participants.
- Analyzed sensitivity, specificity, and predictive values of T-SPOT.TB and TST.
Main Results:
- T-SPOT.TB demonstrated high sensitivity (94.7%) for active TB, comparable in pulmonary and extrapulmonary forms.
- T-SPOT.TB showed good specificity (84.10%), though it varied between pulmonary (69.2%) and extrapulmonary (88.9%) groups.
- TST with 5TU-PPD and 1TU-PPD exhibited significantly lower sensitivity and specificity compared to T-SPOT.TB, with TST 1TU-PPD having a low positive predictive value (33.3%).
Conclusions:
- IGRA (T-SPOT.TB) is a powerful immunodiagnostic tool for active pulmonary and extrapulmonary TB.
- TST is not a reliable test for diagnosing TB disease or infection in BCG-vaccinated individuals.
- IGRA offers a more dependable diagnostic approach compared to TST in this population.
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