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Radiological Signs of Latent Tuberculosis on Chest Radiography: A Systematic Review and Meta-Analysis.
Uzorka, Jonathan W; Wallinga, Jacco; Kroft, Lucia J M; Ottenhoff, Tom H M; Arend, Sandra M.
Afiliação
  • Uzorka JW; Department of Infectious Diseases, Leiden University Medical Center, the Netherlands.
  • Wallinga J; Department of Biomedical Data Sciences, Leiden University Medical Center, the Netherlands.
  • Kroft LJM; Department of Radiology, Leiden University Medical Center, the Netherlands.
  • Ottenhoff THM; Department of Infectious Diseases, Leiden University Medical Center, the Netherlands.
  • Arend SM; Department of Infectious Diseases, Leiden University Medical Center, the Netherlands.
Open Forum Infect Dis ; 6(7)2019 Jul 01.
Article em En | MEDLINE | ID: mdl-31363778
ABSTRACT

OBJECTIVE:

Current guidelines recommend screening for latent tuberculosis infection (LTBI) with a tuberculin skin test (TST) or interferon gamma release assay (IGRA), or both. Many also recommend chest radiography (CXR), although its added value is uncertain. This systematic review assessed the prevalence of abnormalities suggestive of LTBI on CXR (LTBI-CXR lesions) and evaluated the strength of the association.

METHOD:

We searched 4 databases up to September 2017 and systematically reviewed cross-sectional and cohort studies reporting LTBI-CXR lesions in individuals with a positive TST or IGRA, or both, result. Prevalence estimates were pooled using random effects models and odds ratios (ORs) were used to calculate risk estimates.

RESULTS:

In the 26 included studies, the pooled proportion of individuals with LTBI having LTBI-CXR lesions was 0.15 (95% confidence interval [CI], 0.12-0.18]. In 16 studies that reported on individuals with LTBI and uninfected controls, LTBI-CXR lesions were associated with a positive TST result ≥ 5 mm or ≥ 10 mm (OR, 2.45; 95% CI, 1.00-5.99; and OR, 2.06; 95% CI, 1.38-3.09, respectively) and with a positive QuantiFERON result (OR, 1.99; 95% CI, 1.17-3.39) compared to CXR in uninfected controls. Although few studies reported specified lesions, calcified nodules were most frequently reported in individuals with LTBI (proportion, 0.07; 95% CI, 0.02-0.11).

CONCLUSIONS:

Lesions on CXR suggestive of previous infection with Mycobacterium tuberculosis were significantly associated with positive tests for LTBI, although the sensitivity was only 15%. This finding may have added value when detection of past LTBI is important but immunodiagnostic tests may be unreliable.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Idioma: En Ano de publicação: 2019 Tipo de documento: Article