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Abstract
The tuberculin skin test (TST) is used for diagnosing latent TB infection (LTBI). The main limitation of TST is its low sensitivity in populations with the highest risk of progression to active TB: immunosuppressed patients and young children. New IFN-γ-based tests appear as an alternative to the TST. IFN-γ-based tests seem more specific than the TST, being closely associated with LTBI factors, and not being affected by bacillus Calmette–Guérin vaccination. Indeterminate results are mainly related to immunosuppression. Looking at the available data, it seems prudent to recommend the utilization of IFN-γ-based tests after a negative TST result, in order to increase the sensitivity of detecting LTBI cases in severely immunosuppressed patients. In summary, IFN-γ-based tests appear to be a valuable tool, in combination with the TST, for diagnosing TB infection in immunosuppressed patients.
Financial & competing interests disclosure
The authors are members of the Tuberculosis Network European Trials group (TB-NET). Sociedad Española de Neumología y Cirugía Torácica, Societat Catalana de Pneumologia (SOCAP), Fundació Catalana de Pneumologia (FUCAP) and Instituto de Salud Carlos III (RETIC RD06/0018) have supported projects related to diagnosing active and latent TB infection by means of in vitro assays. Irene Latorre is a FPU pre-doctoral student and is the recipient of a grant from the ‘Ministerio de Educación y Ciencia’. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.