Principles and clinical applications of interferon-gamma release assays in latent tuberculosis diagnosis
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Latent tuberculosis (TB) refers to a state in which an individual is infected with Mycobacteriumtuberculosis but shows no clinical symptoms. The World Health Organization estimates that23% of the global population has latent TB, which poses a significant public health challengeowing to the risk of progression to active TB. Diagnosis of latent TB involves tests, such asthe tuberculin skin test (TST) and interferon-gamma release assays (IGRAs). The TST canyield false positives due to prior Bacillus Calmette-Guérin (BCG) vaccination, whereas IGRAsoffer higher specificity and are unaffected by BCG vaccination. Factors, such as age andrecent vaccinations, can affect test performance. Treatment with isoniazid and rifampicin isrecommended for those diagnosed, as it has been shown to prevent 80%-90% of active TBcases, although more extended follow-up studies are needed to confirm its long-term efficacy. Indeterminate IGRA results, especially in immunocompromised individuals, add complexityto the diagnosis and treatment decisions, highlighting the need for careful interpretation. Further research is vital to improve the diagnostic accuracy, interpretation, and treatmenteffectiveness
Abstract
Latent tuberculosis (TB) refers to a state in which an individual is infected with Mycobacteriumtuberculosis but shows no clinical symptoms. The World Health Organization estimates that23% of the global population has latent TB, which poses a significant public health challengeowing to the risk of progression to active TB. Diagnosis of latent TB involves tests, such asthe tuberculin skin test (TST) and interferon-gamma release assays (IGRAs). The TST canyield false positives due to prior Bacillus Calmette-Guérin (BCG) vaccination, whereas IGRAsoffer higher specificity and are unaffected by BCG vaccination. Factors, such as age andrecent vaccinations, can affect test performance. Treatment with isoniazid and rifampicin isrecommended for those diagnosed, as it has been shown to prevent 80%-90% of active TBcases, although more extended follow-up studies are needed to confirm its long-term efficacy. Indeterminate IGRA results, especially in immunocompromised individuals, add complexityto the diagnosis and treatment decisions, highlighting the need for careful interpretation. Further research is vital to improve the diagnostic accuracy, interpretation, and treatmenteffectiveness