T-cell Assays for the Diagnosis of Latent Tuberculosis Infection: Moving the Research Agenda Forward

Lancet Infect Dis. 2007 Jun;7(6):428-38. doi: 10.1016/S1473-3099(07)70086-5.

Abstract

For nearly a century, the tuberculin skin test was the only tool available for the detection of latent tuberculosis infection. A recent breakthrough has been the development of T-cell-based interferon-gamma release assays. Current evidence suggests interferon-gamma release assays have higher specificity than the tuberculin skin test, better correlation with surrogate markers of exposure to Mycobacterium tuberculosis in low-incidence settings, and less cross-reactivity as a result of BCG vaccination compared with the tuberculin skin test. The body of literature supporting the use of interferon-gamma release assays has rapidly expanded. However, several unresolved and unexplained issues remain. To address these issues, a group of experts met in Geneva, Switzerland, in March, 2006, to discuss the research evidence on T-cell-based assays, their clinical usefulness, limitations, and directions for future research, with a specific focus on resource-limited and high HIV prevalence settings. On the basis of 2 days of discussions, a comprehensive research agenda was generated, which will propel the field forward by stimulating focused high-impact research and encourage the investment of resources needed to tackle priority research questions, especially in resource-limited settings. Ultimately, if adequately financed, the research findings will inform appropriate use of novel latent tuberculosis infection diagnostics in global tuberculosis control.

Publication types

  • Consensus Development Conference
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diagnostic Tests, Routine / methods*
  • Diagnostic Tests, Routine / standards
  • Humans
  • Immunity, Cellular
  • Mycobacterium tuberculosis / immunology*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Switzerland
  • T-Lymphocytes / immunology*
  • Tuberculin Test
  • Tuberculosis / diagnosis*
  • Tuberculosis / immunology*