help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on June 23, 2006, doi:10.1164/rccm.200509-1516PP

Am. J. Respir. Crit. Care Med., Volume 174, Number 7, October 2006, 736-742

A more recent version of this article appeared on October 1, 2006
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200509-1516PPv1
174/7/736    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Richeldi, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Richeldi, L.

Submitted on September 28, 2005
Accepted on June 16, 2006

An Update on the Diagnosis of Tuberculosis Infection

Luca Richeldi1*

1 Department of Oncology, Haematology and Respiratory Disease, University of Modena and Reggio Emilia, Modena, Italy

* To whom correspondence should be addressed. E-mail: richeldi.luca{at}unimore.it.

Targeted testing and treatment of individuals with latent tuberculosis infection at increased risk of progression to active disease is a key element of tuberculosis control. This strategy is limited by the poor specificity of the tuberculin skin test in BCG-vaccinated populations and its low sensitivity in immunosuppressed persons, who are at highest risk of progression. Two blood tests (T-SPOT.TB and QuantiFERON-TB Gold), based upon detection of interferon-{gamma} released by T-cells in response to M. tuberculosis-specific antigens, may offer an improvement on the skin test. However, validation is challenging due to the lack of a diagnostic gold standard. This critical appraisal of published evidence summarizes the diagnostic accuracy of the new tests. The blood tests have clear operational advantages over the skin test because no return visit is required, results are available by the next day and repeated testing does not cause boosting. Both tests are significantly more specific than the skin test in BCG-vaccinated populations. The data available suggest that T-SPOT.TB may also be more sensitive than the skin test. Data in groups at high risk of progression to disease are scarce and more research is needed in these populations, but it is already clear that T-SPOT.TB performs better than the skin test in young children and HIV-infected people with active tuberculosis. Incorporation of these tests into programs for targeted testing of latent tuberculosis infection will reduce false-positive and false-negative results inherent in tuberculin testing, equipping clinicians with more accurate tools for tuberculosis control and elimination in the 21st century.
Key words: tuberculosis, diagnosis, interferon-{gamma}, blood test




This article has been cited by other articles:


Home page
 J. Clin. Microbiol.Home page
C. B. E. Chee, S. H. Gan, K. W. KhinMar, T. M. Barkham, C. K. Koh, S. Liang, and Y. T. Wang
Comparison of Sensitivities of Two Commercial Gamma Interferon Release Assays for Pulmonary Tuberculosis
J. Clin. Microbiol., June 1, 2008; 46(6): 1935 - 1940.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A. Strassburg, C. Jafari, M. Ernst, W. Lotz, and C. Lange
Rapid diagnosis of pulmonary TB by BAL enzyme-linked immunospot assay in an immunocompromised host
Eur. Respir. J., May 1, 2008; 31(5): 1132 - 1135.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
Y. Kobashi, K. Mouri, S. Yagi, Y. Obase, N. Miyashita, N. Okimoto, T. Matsushima, T. Kageoka, and M. Oka
Clinical Utility of the QuantiFERON TB-2G Test for Elderly Patients With Active Tuberculosis
Chest, May 1, 2008; 133(5): 1196 - 1202.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
P. Beffa, A. Zellweger, J-P. Janssens, P. Wrighton-Smith, and J-P. Zellweger
Indeterminate test results of T-SPOTTM.TB performed under routine field conditions
Eur. Respir. J., April 1, 2008; 31(4): 842 - 846.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
D. P.S. Dosanjh, T. S.C. Hinks, J. A. Innes, J. J. Deeks, G. Pasvol, S. Hackforth, H. Varia, K. A. Millington, R. Gunatheesan, V. Guyot-Revol, et al.
Improved Diagnostic Evaluation of Suspected Tuberculosis
Ann Intern Med, March 4, 2008; 148(5): 325 - 336.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
C. C. Leung, W. C. Yam, W. W. Yew, P. L. Ho, C. M. Tam, W. S. Law, M. Y. Wong, M. Leung, and D. Tsui
Comparison of T-Spot.TB and tuberculin skin test among silicotic patients
Eur. Respir. J., February 1, 2008; 31(2): 266 - 272.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
C. Jafari, M. Ernst, A. Strassburg, U. Greinert, B. Kalsdorf, D. Kirsten, and C. Lange
Local immunodiagnosis of pulmonary tuberculosis by enzyme-linked immunospot
Eur. Respir. J., February 1, 2008; 31(2): 261 - 265.
[Abstract] [Full Text] [PDF]

Home page
 CVIHome page
R. Palazzo, F. Spensieri, M. Massari, G. Fedele, L. Frasca, S. Carrara, D. Goletti, and C. M. Ausiello
Use of Whole-Blood Samples in In-House Bulk and Single-Cell Antigen-Specific Gamma Interferon Assays for Surveillance of Mycobacterium tuberculosis Infections
Clin. Vaccine Immunol., February 1, 2008; 15(2): 327 - 337.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. Losi, A. Bossink, L. Codecasa, C. Jafari, M. Ernst, S. Thijsen, D. Cirillo, M. Ferrarese, U. Greinert, L. M. Fabbri, et al.
Use of a T-cell interferon-{gamma} release assay for the diagnosis of tuberculous pleurisy
Eur. Respir. J., December 1, 2007; 30(6): 1173 - 1179.
[Abstract] [Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
A. Pratt, K. Nicholl, and L. Kay
Comment on: Use of the QuantiFERON-TB(R) Gold test as part of a screening programme in patients with RA under consideration for treatment with anti-TNF-{alpha} agents: the Newcastle (UK) experience: reply
Rheumatology, December 1, 2007; 46(12): 1864 - 1865.
[Full Text] [PDF]

Home page
 J Am Board Fam MedHome page
M. G. Madariaga, Z. Jalali, and S. Swindells
Clinical Utility of Interferon Gamma Assay in the Diagnosis of Tuberculosis
J Am Board Fam Med, November 1, 2007; 20(6): 540 - 547.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
Y. Kobashi, K. Mouri, Y. Obase, M. Fukuda, N. Miyashita, and M. Oka
Clinical evaluation of QuantiFERON TB-2G test for immunocompromised patients
Eur. Respir. J., November 1, 2007; 30(5): 945 - 950.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
U. R. Dahle, V. Eldholm, B. A. Winje, T. Mannsaker, and E. Heldal
Impact of Immigration on the Molecular Epidemiology of Mycobacterium tuberculosis in a Low-Incidence Country
Am. J. Respir. Crit. Care Med., November 1, 2007; 176(9): 930 - 935.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
J-P. Janssens, P. Roux-Lombard, T. Perneger, M. Metzger, R. Vivien, and T. Rochat
Quantitative scoring of an interferon-{gamma} assay for differentiating active from latent tuberculosis
Eur. Respir. J., October 1, 2007; 30(4): 722 - 728.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
Y. A. Kang, H. W. Lee, S. S. Hwang, S.-W. Um, S. K. Han, Y.-S. Shim, and J.-J. Yim
Usefulness of Whole-Blood Interferon-{gamma} Assay and Interferon-{gamma} Enzyme-Linked Immunospot Assay in the Diagnosis of Active Pulmonary Tuberculosis
Chest, September 1, 2007; 132(3): 959 - 965.
[Abstract] [Full Text] [PDF]

Home page
 CVIHome page
T. G. Connell, M. S. Shey, R. Seldon, M. X. Rangaka, G. van Cutsem, M. Simsova, Z. Marcekova, P. Sebo, N. Curtis, L. Diwakar, et al.
Enhanced Ex Vivo Stimulation of Mycobacterium tuberculosis-Specific T Cells in Human Immunodeficiency Virus-Infected Persons via Antigen Delivery by the Bordetella pertussis Adenylate Cyclase Vector
Clin. Vaccine Immunol., July 1, 2007; 14(7): 847 - 854.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. Lalvani
Diagnosing Tuberculosis Infection in the 21st Century: New Tools To Tackle an Old Enemy
Chest, June 1, 2007; 131(6): 1898 - 1906.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. K. Reid, H. Ward, D. Marciniuk, S. Hudson, P. Smith, and V. Hoeppner
The Effect of Neonatal Bacille Calmette-Guerin Vaccination on Purified Protein Derivative Skin Test Results in Canadian Aboriginal Children
Chest, June 1, 2007; 131(6): 1806 - 1810.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
B. J Marais and M. Pai
Recent advances in the diagnosis of childhood tuberculosis
Arch. Dis. Child., May 1, 2007; 92(5): 446 - 452.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. X. Rangaka, K. A. Wilkinson, R. Seldon, G. Van Cutsem, G. A. Meintjes, C. Morroni, P. Mouton, L. Diwakar, T. G. Connell, G. Maartens, et al.
Effect of HIV-1 Infection on T-Cell-based and Skin Test Detection of Tuberculosis Infection
Am. J. Respir. Crit. Care Med., March 1, 2007; 175(5): 514 - 520.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. Richeldi
Should Individuals Who Are Tuberculin Skin Test Negative and Positive to RD1-IFN-{gamma} Assay Receive Preventive Therapy?
Am. J. Respir. Crit. Care Med., January 15, 2007; 175(2): 200 - 200.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
E. Girardi, D. Goletti, and G. Ippolito
Should Individuals Who Are Tuberculin Skin Test Negative and Positive to RD1-IFN-{gamma} Assay Receive Preventive Therapy?
Am. J. Respir. Crit. Care Med., January 15, 2007; 175(2): 198a - 199.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. J. Radford, J. S. Rothel, S. L. Jones, and G. Sberna
Tuberculosis diagnostic tests: sensitivity, specificity, and comparing apples with apples.
Am. J. Respir. Crit. Care Med., October 15, 2006; 174(8): 953 - 953.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. Richeldi
Tuberculosis diagnostic tests: sensitivity, specificity, and comparing apples with apples.
Am. J. Respir. Crit. Care Med., October 15, 2006; 174(8): 953a - 9954.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. F. Barnes
Weighing gold or counting spots: which is more sensitive to diagnose latent tuberculosis infection?
Am. J. Respir. Crit. Care Med., October 1, 2006; 174(7): 731 - 732.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2006 American Thoracic Society