Interferon- release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis
| Autor: | Marc Lipman, Emma Huitric, Stefan Winkler, Pernille Ravn, José Domínguez, Claudia Giehl, Enrico Girardi, Martina Sester, Christoph Lange, Keertan Dheda, Johannes Nemeth, Andreas Sandgren, Roland Diel, Giovanni Battista Migliori, Aik Bossink, Giovanni Sotgiu, Davide Manissero |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Pulmonary and Respiratory Medicine medicine.medical_specialty Tuberculosis Tuberculin Mycobacterium tuberculosis Interferon-gamma Tuberculosis diagnosis Predictive Value of Tests Internal medicine Odds Ratio medicine Humans Child Prospective cohort study T-SPOT.TB Clinical Trials as Topic Mycobacterium Infections biology Tuberculin Test business.industry Reproducibility of Results medicine.disease biology.organism_classification Meta-analysis Predictive value of tests Multivariate Analysis Immunology Reagent Kits Diagnostic business Algorithms |
| Zdroj: | European Respiratory Journal. 37:100-111 |
| ISSN: | 1399-3003 0903-1936 |
| DOI: | 10.1183/09031936.00114810 |
| Popis: | Interferon-γ release assays (IGRAs) are now established for the immunodiagnosis of latent infection with Mycobacterium tuberculosis in many countries. However, the role of IGRAs for the diagnosis of active tuberculosis (TB) remains unclear. Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) and quality assessment of diagnostic accuracy studies (QUADAS) guidelines, we searched PubMed, EMBASE and Cochrane databases to identify studies published in January 2001-November 2009 that evaluated the evidence of using QuantiFERON-TB® Gold in-tube (QFT-G-IT) and T-SPOT.TB® directly on blood or extrasanguinous specimens for the diagnosis of active TB. The literature search yielded 844 studies and 27 met the inclusion criteria. In blood and extrasanguinous fluids, the pooled sensitivity for the diagnosis of active TB was 80% (95% CI 75-84%) and 48% (95% CI 39-58%) for QFT-G-IT, and 81% (95% CI 78-84%) and 88% (confirmed and unconfirmed cases) (95% CI 82-92%) for T-SPOT.TB®, respectively. In blood and extrasanguinous fluids, the pooled specificity was 79% (95% CI 75-82%) and 82% (95% CI 70-91%) for QFT-G-IT, and 59% (95% CI 56-62%) and 82% (95% CI 78-86%) for T-SPOT.TB®, respectively. Although the diagnostic sensitivities of both IGRAs were higher than that of tuberculin skin tests, it was still not high enough to use as a rule out test for TB. Positive evidence for the use of IGRAs in compartments other than blood will require more independent and carefully designed prospective studies. |
| Databáze: | OpenAIRE |
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