Added value of interferon-gamma release assays in screening for tuberculous infection in the Netherlands.
Int J Tuberc Lung Dis
; 18(4): 413-20, 2014 Apr.
Article
em En
| MEDLINE
| ID: mdl-24670695
ABSTRACT
BACKGROUND:
Interferon-gamma release assays (IGRAs) are reported to be more specific for the diagnosis of latent tuberculous infection (LTBI) than the tuberculin skin test (TST). The two-step procedure, TST followed by an IGRA, is reported to be cost-effective in high-income countries, but it requires more financial resources.OBJECTIVE:
To assess the added value of IGRA compared to TST alone in the Netherlands.METHODS:
Test results and background data on persons tested with an IGRA were recorded by the Public Municipal Health Services in a web-based database. The number of persons diagnosed with LTBI using different screening algorithms was calculated.RESULTS:
In those tested with an IGRA, at least 60% of persons who would have been diagnosed with LTBI based on TST alone had a negative IGRA. Among those with a TST reaction below the cut-off for the diagnosis of LTBI, 13% had a positive IGRA. For 41% of persons tested with an IGRA after TST, the IGRA influenced whether or not an LTBI diagnosis would be made.CONCLUSION:
With the IGRA as reference standard, a high proportion of persons in low-prevalence settings are treated unnecessarily for LTBI if tested with TST alone, while a small proportion eligible for preventive treatment are missed. Incremental costs of the two-step strategy seem to be balanced by the improved targeting of preventive treatment.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Teste Tuberculínico
/
Tuberculose Latente
/
Testes de Liberação de Interferon-gama
/
Mycobacterium tuberculosis
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article