TY - JOUR
T1 - Tuberculin skin test – Outdated or still useful for Latent TB infection screening?
AU - Gualano, Gina
AU - Mencarini, Paola
AU - Lauria, Francesco Nicola
AU - Palmieri, Fabrizio
AU - Mfinanga, Sayoki
AU - Mwaba, Peter
AU - Chakaya, Jeremiah
AU - Zumla, Alimuddin
AU - Ippolito, Giuseppe
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Objective: To make an informed viewpoint on the usefulness of Tuberculin Skin test (TST) compared to Interferon Gamma Release Assays (IGRAs) for diagnosis of Latent TB Infection (LTBI) in different geographical settings. Methods: We reviewed the current literature on TST compared to IGRA, including national implementation of WHO LTBI recommendations and retrospective data over the past 7 years at the National Institute for Infectious Diseases “L. Spallanzani” as indirect indicator of usage of both tests under actual programmatic conditions. Results: Current national guidelines vary considerably, reflecting the uncertainty and rapidly evolving evidence about the potential use of these tests. Data from Institute “L. Spallanzani” showed IGRA concordance in TST positive subjects only in 54.74% of subjects, while there was strong concordance between two tests in TST negative subjects (93.78%). Conclusion: Neither IGRAs nor TST can distinguish active TB from LTBI. TST will continue to be clinically useful in low and high TB endemic areas until more accurate and predictive tests will become available. Clinical judgment remains fundamental in choosing between IGRA/TST tests and interpreting their results.
AB - Objective: To make an informed viewpoint on the usefulness of Tuberculin Skin test (TST) compared to Interferon Gamma Release Assays (IGRAs) for diagnosis of Latent TB Infection (LTBI) in different geographical settings. Methods: We reviewed the current literature on TST compared to IGRA, including national implementation of WHO LTBI recommendations and retrospective data over the past 7 years at the National Institute for Infectious Diseases “L. Spallanzani” as indirect indicator of usage of both tests under actual programmatic conditions. Results: Current national guidelines vary considerably, reflecting the uncertainty and rapidly evolving evidence about the potential use of these tests. Data from Institute “L. Spallanzani” showed IGRA concordance in TST positive subjects only in 54.74% of subjects, while there was strong concordance between two tests in TST negative subjects (93.78%). Conclusion: Neither IGRAs nor TST can distinguish active TB from LTBI. TST will continue to be clinically useful in low and high TB endemic areas until more accurate and predictive tests will become available. Clinical judgment remains fundamental in choosing between IGRA/TST tests and interpreting their results.
KW - IGRA
KW - Interferon-γ release assays
KW - Latent TB
KW - LTBI
KW - Quantiferon
KW - TB
KW - TST
KW - Tuberculin skin test
KW - Tuberculosis
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U2 - 10.1016/j.ijid.2019.01.048
DO - 10.1016/j.ijid.2019.01.048
M3 - Article
C2 - 30738186
AN - SCOPUS:85061941061
VL - 80
SP - S20-S22
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -