IFN-γ release assays in tuberculosis management in selected high-risk populations

Bocchino, Marialuisa; Bellofiore, Barbara; Matarese, Alessandro; Galati, Domenico; Sanduzzi, Alessandro

doi:10.1586/14737159.9.2.165

Cited by 16 publications

(16 citation statements)

References 79 publications

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“…The performance of IGRAs is impaired for HIV-infected patients with advanced immunodeficiency. Higher rates of indeterminate results are found for patients with CD4 counts below 100 cells/l, due to low levels of IFN-␥ in response to stimulation with the positive control (24).…”

Section: Ifn-␥ Release Assays For Hiv-infected Patientsmentioning

confidence: 95%

“…These assays detect the release of the cytokine gamma interferon (IFN-␥) from T lymphocytes after stimulation with the M. tuberculosis-specific antigens early secretory antigen target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) and also TB antigen TB 7.7 for the QFT-GIT test (24,74). The QuantiFERON assays use anticoagulated whole blood and measure the release of gamma interferon into the supernatant by enzyme-linked immunosorbent assays (ELISAs), while the T-SPOT.TB assay uses isolated blood mononuclear cells and determines the number of gamma interferon-secreting cells in the sample by using an enzymelinked immunospot (ELISPOT) technique (24,74). Each test is performed with a negative control and a positive control, and results are reported as being indeterminate if there is a high signal for the negative control or a low signal for the positive control.…”

Section: Ifn-␥ Release Assays For Hiv-infected Patientsmentioning

confidence: 99%

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HIV and Tuberculosis: a Deadly Human Syndemic

2011

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SUMMARY A syndemic is defined as the convergence of two or more diseases that act synergistically to magnify the burden of disease. The intersection and syndemic interaction between the human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics have had deadly consequences around the world. Without adequate control of the TB-HIV syndemic, the long-term TB elimination target set for 2050 will not be reached. There is an urgent need for additional resources and novel approaches for the diagnosis, treatment, and prevention of both HIV and TB. Moreover, multidisciplinary approaches that consider HIV and TB together, rather than as separate problems and diseases, will be necessary to prevent further worsening of the HIV-TB syndemic. This review examines current knowledge of the state and impact of the HIV-TB syndemic and reviews the epidemiological, clinical, cellular, and molecular interactions between HIV and TB.

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Section: Ifn-␥ Release Assays For Hiv-infected Patientsmentioning

confidence: 95%

Section: Ifn-␥ Release Assays For Hiv-infected Patientsmentioning

confidence: 99%

HIV and Tuberculosis: a Deadly Human Syndemic

2011

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“…39 However some studies have shown that IGRAs (particularly the TBSPOT.TB assay) might be more sensitive than the TST in detecting latent TB infection in people who are HIV infected with severe immune suppression. [40][41][42][43][44][45][46][47] A study in South Africa demonstrated that patients with very low CD4 counts who had recently been treated for active TB had high rates of response using the TSPOT.TB test. This study suggested that the TSPOT.TB has utility even in a population that had a mean CD4 + T-cell count of 98.…”

Section: Discussionmentioning

confidence: 99%

Recent Advances in Testing for Latent TB

Schluger

Burzynski

2010

Chest

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Exposure to a person with infectious TB can result in one of three outcomes: the innate immune system can clear the infection immediately, leaving no evidence of exposure to TB; Mycobacterium tuberculosis organisms can begin to proliferate immediately, causing so-called primary TB; or the growth of organisms can be controlled or contained but not stopped by the host patient's immune response, setting up a state of latent infection. In this state, viable organisms are contained intracellularly within macrophages and within granulomas. 1 People with latent TB are at risk for active TB disease. Lifetime risk of active TB in patients with latent infection, as detected by means of a tuberculin skin test (TST), is estimated to be in the 5% to 10% range, with roughly one-half of that risk occurring in the fi rst year or two after latent infection develops. In addition, the risk of development of reactivation is greater in people with medical conditions associated with immunosuppression, such as infection with HIV or treatment with drugs such as corticosteroids or tumor necrosis factor antagonists. 2 In the United States, treatment of latent infection is a key component of the overall public health plan for controlling TB. 3 Cases of active TB in the United States have fallen steadily since 1992, and the overall rate of TB in this country now stands at 4.3/100,000, the lowest prevalence that has been recorded here. 4 The sharp decline in TB in the United States over the last several years has largely come about because of efforts aimed at diagnosing and treating patients with active disease, thereby reducing transmission and secondary cases. However, if TB is to be eliminated in this country (a stated goal of the US Public Health Service), there is no question that efforts in treating latent TB must be strengthened. 5 A recent study estimates that there is a reservoir of at least 20 million people in this country with latent TB infection, and without treatment, a large number of them will progress to active disease. 6 Furthermore, the majority of cases of active TB in this country now occur in people born outside the United States, and treating latent infection in recent immigrants from high-prevalence countries is the only way to prevent cases of active disease from developing.For the past several years, the US Centers for Disease Control and Prevention (CDC) has emphasized After more than a century of relying on skin testing for the diagnosis of latent TB infection, clinicians now have access to blood-based diagnostics in the form of interferon g release assays (IGRAs). These tests are generally associated with higher sensitivity and specifi city for diagnosis of latent TB infection. This article reviews the indications for testing and treatment of latent TB infection in the overall context of a TB control program and describes how IGRAs might be used in specifi c clinical settings and populations, including people having close contact with an active case of TB, the foreign born, and health-care workers.CHEST 2010; 13...

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“…Several publications have shown the accuracy of the TB IGRA (14)(15)(16)(17). These assays are now used in a number of countries worldwide (17)(18)(19).…”

Section: Advantagesmentioning

confidence: 99%

“…The use of these specific proteins results in improved specificity compared to the use of TST to detect active TB disease. Additionally, studies show the use of IGRAs in screening for active tuberculosis is cost-effective, especially when screening high-risk populations, such as immigrants, close contacts of individuals with active tuberculosis, and health care workers (12,14,(20)(21)(22)(23).…”

Section: Advantagesmentioning

confidence: 99%

Gamma Interferon Assays Used in the Diagnosis of Tuberculosis

Horvat

2015

Clin Vaccine Immunol

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Tuberculosis (TB) is an ancient disease that has infected humans for thousands of years. However, despite diagnostic tests that detect the disease and effective therapy, there are still millions of people worldwide who are infected with TB. The first TB test used to detect infected patients was a skin test that identifies individuals actively infected with TB. This test used a mix of proteins from culture filtrates of the bacteria Mycobacterium tuberculosis. Recently, two new diagnostic tests have been introduced; these two new tests can detect TB infection in patients by challenging peripheral blood cells with specific TB proteins. These assays measure the cellular immune response to these proteins. This minireview evaluates the new assays and compares them to the use of the TB skin test. The use of these new assays may have some advantages in detecting individuals with active tuberculosis. However, there is still a role for the use of the skin test, especially in young patients.

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IFN-γ release assays in tuberculosis management in selected high-risk populations

Cited by 16 publications

References 79 publications

HIV and Tuberculosis: a Deadly Human Syndemic

HIV and Tuberculosis: a Deadly Human Syndemic

Recent Advances in Testing for Latent TB

Gamma Interferon Assays Used in the Diagnosis of Tuberculosis

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