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Tuberculin Skin Test – outdated or still useful for Latent TB Infection screening?

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Gualano, Gina, Mencarini, Paola, Lauria, Francesco Nicola, Palmieri, Fabrizio, Mfinanga, Sayoki, Mwaba, Peter, Chakaya, Jeremiah, Zumla, Alimuddin and Ippolito, Giuseppe (2019) 'Tuberculin Skin Test – outdated or still useful for Latent TB Infection screening?'. International Journal of Infectious Diseases, Vol 80, S20-S22.

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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

Item Type: Article
Subjects: WB Practice of Medicine > WB 102 Clinical medicine
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1016/j.ijid.2019.01.048
Depositing User: Stacy Murtagh
Date Deposited: 11 Feb 2019 16:15
Last Modified: 27 Mar 2019 16:17
URI: http://archive.lstmed.ac.uk/id/eprint/10145

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