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Tuberculin skin test - Outdated or still useful for Latent TB infection screening?

Gualano, G; Mencarini, P; Lauria, FN; Palmieri, F; Mfinanga, S; Mwaba, P; Chakaya, J; ... Ippolito, G; + view all (2019) Tuberculin skin test - Outdated or still useful for Latent TB infection screening? International Journal of Infectious Diseases , 80 S20-S22. 10.1016/j.ijid.2019.01.048. Green open access

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Abstract

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.

Type: Article
Title: Tuberculin skin test - Outdated or still useful for Latent TB infection screening?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ijid.2019.01.048
Publisher version: http://doi.org/10.1016/j.ijid.2019.01.048
Language: English
Additional information: Copyright © 2019 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Tuberculin skin test, TST, Interferon-g release assays, IGRA, Tuberculosis, Quantiferon, TB, Latent TB, LTBI
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: https://discovery.ucl.ac.uk/id/eprint/10071189
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