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Diagnosis of Latent Tuberculosis Infection

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  • Authors: Alfred A. Lardizabal1, Lee B. Reichman2
  • Editor: David Schlossberg3
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: New Jersey Medical School Global Tuberculosis Institute, Rutgers University, Newark, NJ 07103; 2: New Jersey Medical School Global Tuberculosis Institute, Rutgers University, Newark, NJ 07103; 3: Philadelphia Health Department, Philadelphia, PA
  • Source: microbiolspec February 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0019-2016
  • Received 03 October 2016 Accepted 13 October 2016 Published 10 February 2017
  • Alfred A. Lardizabal, lardizaa@njms.rutgers.edu
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  • Abstract:

    For 2015, tuberculosis (TB) incidence in the United States has plateaued at 3.0 per 100,000. This remains the lowest case rate since recording started. On the global level, although the TB epidemic is larger than previously estimated, TB deaths and incidence rate continue to fall. For both low and high incidence countries, accelerating the decline in TB incidence towards elimination goals requires that more emphasis be placed on strengthening systems for detection and treatment of latent TB infection (LTBI) in addition to improving TB care globally. Here, we review the tuberculin skin test and gamma interferon release assays currently available for the detection of LTBI.

  • Citation: Lardizabal A, Reichman L. 2017. Diagnosis of Latent Tuberculosis Infection. Microbiol Spectrum 5(1):TNMI7-0019-2016. doi:10.1128/microbiolspec.TNMI7-0019-2016.

Key Concept Ranking

Enzyme-Linked Immunosorbent Assay
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References

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10. Reichman LB, O’Day R. 1978. Tuberculous infection in a large urban population. Am Rev Respir Dis 117:705–712. [PubMed]
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12. Menzies R, Vissandjee B. 1992. Effect of bacille Calmette-Guérin vaccination on tuberculin reactivity. Am Rev Respir Dis 145:621–625. [PubMed]
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14. Centers for Disease Control and Prevention. 2000. Core Curriculum on Tuberculosis, 4th ed. US Government Printing Office, Washington, DC.
15. Reichman LB, O’Day R. 1977. The influence of a history of a previous test on the prevalence and size of reactions to tuberculin. Am Rev Respir Dis 115:737–741. [PubMed]
16. Thompson NJ, Glassroth JL, Snider DE, Jr, Farer LS. 1979. The booster phenomenon in serial tuberculin testing. Am Rev Respir Dis 119:587–597. [PubMed]
17. American Thoracic Society. 1992. Control of tuberculosis in the United States. Am Rev Respir Dis 146:1623–1633. [PubMed]
18. Bibbins-Domingo K, Grossman DC, Curry SJ, Bauman L, Davidson KW, Epling JW, Jr, García FA, Herzstein J, Kemper AR, Krist AH, Kurth AE, Landefeld CS, Mangione CM, Phillips WR, Phipps MG, Pignone MP, US Preventive Services Task Force. 2016. Screening for latent tuberculosis infection in adults: US Preventive Services Task Force recommendation statement. JAMA 316:962–969. [PubMed]
19. Brock I, Weldingh K, Lillebaek T, Follmann F, Andersen P. 2004. Comparison of a new specific blood test and the skin test in tuberculosis contacts. Am J Respir Crit Care Med 170:65–69. [PubMed]
20. Mazurek GH, LoBue PA, Daley CL, Bernardo J, Lardizabal AA, Bishai WR, Iademarco MF, Rothel JS. 2001. Comparison of a whole-blood interferon gamma assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection. JAMA 286:1740–1747. [PubMed]
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23. Hill PC, Brookes RH, Fox A, Fielding K, Jeffries DJ, Jackson-Sillah D, Lugos MD, Owiafe PK, Donkor SA, Hammond AS, Otu JK, Corrah T, Adegbola RA, McAdam KP. 2004. Large-scale evaluation of enzyme-linked immunospot assay and skin test for diagnosis of Mycobacterium tuberculosis infection against a gradient of exposure in The Gambia. Clin Infect Dis 38:966–973. [PubMed]
24. Lalvani A, Pathan AA, Durkan H, Wilkinson KA, Whelan A, Deeks JJ, Reece WHH, Latif M, Pasvol G, Hill AV. 2001. Enhanced contact tracing and spatial tracking of Mycobacterium tuberculosis infection by enumeration of antigen-specific T cells. Lancet 357:2017–2021.
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28. Diel R, Loddenkemper R, Meywald-Walter K, Niemann S, Nienhaus A. 2008. Predictive value of a whole blood IFN-gamma assay for the development of active tuberculosis disease after recent infection with Mycobacterium tuberculosis. Am J Respir Crit Care Med 177:1164–1170. [PubMed]
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/content/journal/microbiolspec/10.1128/microbiolspec.TNMI7-0019-2016
2017-02-10
2017-12-15

Abstract:

For 2015, tuberculosis (TB) incidence in the United States has plateaued at 3.0 per 100,000. This remains the lowest case rate since recording started. On the global level, although the TB epidemic is larger than previously estimated, TB deaths and incidence rate continue to fall. For both low and high incidence countries, accelerating the decline in TB incidence towards elimination goals requires that more emphasis be placed on strengthening systems for detection and treatment of latent TB infection (LTBI) in addition to improving TB care globally. Here, we review the tuberculin skin test and gamma interferon release assays currently available for the detection of LTBI.

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Figures

Image of FIGURE 1
FIGURE 1

Distribution of reactions to 5 TU of PPD among Alaskans tested in 1962. Reprinted with permission from ( 6 ).

Source: microbiolspec February 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0019-2016
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Image of FIGURE 2
FIGURE 2

Distribution of reactions to 5 TU of PPD among white Navy recruits from the state of Georgia, with estimate of proportion infected with . Reprinted with permission from ( 7 ).

Source: microbiolspec February 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0019-2016
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Image of FIGURE 3
FIGURE 3

Schema of probable distribution of reactors to 5 TU of PPD in the New York City metropolitan area.

Source: microbiolspec February 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0019-2016
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Image of FIGURE 4
FIGURE 4

Schematic representation of three booster effect possibilities. (See text for discussion.)

Source: microbiolspec February 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0019-2016
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Tables

Generic image for table
TABLE 1

Criteria for tuberculin positivity, by risk group

Source: microbiolspec February 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0019-2016

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