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Expert Rev Respir Med. 2009 Jun;3(3):309-27. doi: 10.1586/ers.09.20.

IFN-gamma-release assays to diagnose TB infection in the immunocompromised individual.

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Servei de Microbiologia, Fundació Institut d'Investigació en Ciències de la Salut 'Germans Trias i Pujol', Carretera del Canyet s/n, 08916 Badalona, Barcelona, Spain and, Universitat Autònoma de Barcelona, Bellaterra, Spain and, CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Barcelona, Spain.


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-gamma-based tests appear as an alternative to the TST. IFN-gamma-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-gamma-based tests after a negative TST result, in order to increase the sensitivity of detecting LTBI cases in severely immunosuppressed patients. In summary, IFN-gamma-based tests appear to be a valuable tool, in combination with the TST, for diagnosing TB infection in immunosuppressed patients.


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