The treatment of latent tuberculosis infection (LTBI) in target populations is one of the current WHO strategies for preventing active tuberculosis (TB) infection and reducing theT he screening and treatment for LTBI in target populations in order to prevent TB and reduce the Mycobacterium tuberculosis reservoir are some of the main strategies of the WHO's Global Plan to Stop TB (http://www.who.int/tb/publications/global _report/en). However, a major obstacle to the instauration and effectiveness of these preventive measures resides in the lack of a gold standard LTBI screening tool.For several decades, the tuberculin skin test (TST) has been the main screening test for LTBI despite its lack of both sensitivity and specificity (1). Subsequently, T-cell-based gamma interferon release assays (IGRAs) in response to antigens encoded in the M. tuberculosis genomic region of difference 1 (RD-1) and RD-11 were developed and commercialized (QuantiFERON-TB Gold In-Tube [QFT-GIT] and T-SPOT.TB tests), with the objective of offering a more powerful diagnostic tool for LTBI. These tests offer a higher specificity than TST particularly in countries with high Mycobacterium bovis BCG vaccination coverage (2). However, recent studies suggest that these short-incubation RD-1-based IGRAs may have suboptimal sensitivities (3, 4).An alternative IGRA in response to the native mycobacterial antigen heparin-binding hemagglutinin (nHBHA-IGRA) that uses a longer incubation time than the commercialized IGRA has been validated in immunocompetent adults in the screening for LTBI (5). This assay not only demonstrates a high sensitivity and specificity for LTBI diagnosis but also a capacity to detect remote M. tuberculosis infections, a substantial advantage over the commercialized IGRAs (5-7).Remote M. tuberculosis infections are generally believed to be identified through central memory T-cell (Tcm) responses detected with long-incubation IGRAs (3, 4). Here, however, we demonstrate that both recent and remote M. tuberculosis infections can be identified through effector memory T-cell (Tem) responses using a short-incubation nHBHA-IGRA, the upgraded assay presented in this study. Our results suggest that the detection of IFN-␥-producing CD4 ϩ Tem in response to nHBHA reflects the persistence of M. tuberculosis antigens and therefore a true state of latency.(These results were presented in part at the European Congress of Immunology, Glasgow, Scotland, 5 to 8 September 2012, and at the MycoClub,