Laura Muñoz1, Miguel Santin. 1. Department of Infectious Diseases, Bellvitge University Hospital - IDIBELL, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
Abstract
OBJECTIVES: To assess whether Interferon-γ release assays (IGRAs) reduce the number of people considered for tuberculosis (TB) preventive treatment without increasing subsequent active disease. METHODS: Longitudinal studies with both tuberculin skin test (TST) and IGRAs were identified through a PubMed search. Reductions in diagnosis of TB infection and increases in incident TB in people considered not infected, using IGRAs either instead of TST or as a confirmatory test (two-step approach), were assessed. RESULTS: In comparison with TST alone, the pooled reductions in diagnosis of TB infection obtained with IGRAs were 16.7% and 5.8% at 5 and 10 mm cut-offs respectively, and 24.5% and 12.4% at 5 and 10 mm respectively with the two-step approach. Compared with TST alone, incident TB among people considered not infected increased with the two-step approach (0.94% with T-SPOT(®).TB and 1.1% with QuantiFERON(®)-TB Gold In-Tube) in one of seven studies in high-income countries. In middle- and low-income countries, two of four studies presented increases (0.08 and 0.03 per 100 patient-years respectively) with the two-step approach. CONCLUSIONS: In high-income countries, the use of IGRAs, either instead of TST or as confirmatory test reduces the number of people considered for preventive treatment, without a significant risk of subsequent active disease.
OBJECTIVES: To assess whether Interferon-γ release assays (IGRAs) reduce the number of people considered for tuberculosis (TB) preventive treatment without increasing subsequent active disease. METHODS: Longitudinal studies with both tuberculin skin test (TST) and IGRAs were identified through a PubMed search. Reductions in diagnosis of TB infection and increases in incident TB in people considered not infected, using IGRAs either instead of TST or as a confirmatory test (two-step approach), were assessed. RESULTS: In comparison with TST alone, the pooled reductions in diagnosis of TB infection obtained with IGRAs were 16.7% and 5.8% at 5 and 10 mm cut-offs respectively, and 24.5% and 12.4% at 5 and 10 mm respectively with the two-step approach. Compared with TST alone, incident TB among people considered not infected increased with the two-step approach (0.94% with T-SPOT(®).TB and 1.1% with QuantiFERON(®)-TB Gold In-Tube) in one of seven studies in high-income countries. In middle- and low-income countries, two of four studies presented increases (0.08 and 0.03 per 100 patient-years respectively) with the two-step approach. CONCLUSIONS: In high-income countries, the use of IGRAs, either instead of TST or as confirmatory test reduces the number of people considered for preventive treatment, without a significant risk of subsequent active disease.
Authors: Laura Muñoz; Aina Gomila; Susana Casas; José Castellote; Montserrat Arnan; Antoni Rafecas; Miguel Santin Journal: Transplant Direct Date: 2015-04-01
Authors: Dae Hyun Jeong; Jieun Kang; Young Ju Jung; Bin Yoo; Chang-Keun Lee; Yong-Gil Kim; Seokchan Hong; Tae Sun Shim; Kyung-Wook Jo Journal: PLoS One Date: 2018-07-05 Impact factor: 3.240
Authors: Eugenia Carrillo; Nerea Carrasco-Antón; Francisco López-Medrano; Efrén Salto; Laura Fernández; Juan Víctor San Martín; Jorge Alvar; Jose María Aguado; Javier Moreno Journal: PLoS Negl Trop Dis Date: 2015-10-23
Authors: Laura Muñoz; Lucia Gonzalez; Laura Soldevila; Jordi Dorca; Fernando Alcaide; Miguel Santin Journal: PLoS One Date: 2017-08-30 Impact factor: 3.240