RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

Background: It remains uncertain if interferon-γ release assays (IGRAs) are superior to the tuberculin skin test (TST) for the diagnosis of active tuberculosis (TB) or latent tuberculosis infection (LTBI) in immunosuppressed populations including people with human immunodeficiency virus (HIV) infection. The purpose of this study was to systematically review the performance of IGRAs and the TST in people with HIV with active TB or LTBI in low and high prevalence TB countries.
Methods: We searched the MEDLINE database from 1966 through to January 2017 for studies that compared results of the TST with either the commercial QuantiFERON-TB Gold in Tube (QFTGT) assay or previous assay versions, the T-SPOT.TB assay or in-house IGRAs. Data were summarized by TB prevalence. Tests for concordance and differences in proportions were undertaken as appropriate. The variation in study methodology was appraised.
Results: Thirty-two studies including 4,856 HIV subjects met the search criteria. Fourteen studies compared the tests in subjects with LTBI in low TB prevalence settings. The QFTGT had a similar rate of reactivity to the TST, although the first-generation version of that assay was reactive more commonly. IGRAs were more frequently positive than the TST in HIV infected subjects with active TB. There was considerable study methodology and population heterogeneity, and generally low concordance between tests. Both the TST and IGRAs were affected by CD4 T-cell immunodeficiency.
Conclusion: Our review of comparative data does not provide robust evidence to support the assertion that the IGRAs are superior to the TST when used in HIV infected subjects to diagnose either active TB or LTBI.

참고문헌 (Reference)

1 van Zyl-Smit RN, "Within-subject variability of interferon-g assay results for tuberculosis and boosting effect of tuberculin skin testing: a systematic review" 4 : e8517-, 2009

2 Jones S, "Utility of QuantiFERON-TB Gold in-tube testing for latent TB infection in HIV-infected individuals" 11 : 1190-1195, 2007

3 Mori T, "Usefulness of interferon-gamma release assays for diagnosing TB infection and problems with these assays" 15 : 143-155, 2009

4 Telisinghe L, "The sensitivity of the QuantiFERON(R)-TB Gold Plus assay in Zambian adults with active tuberculosis" 21 : 690-696, 2017

5 Raby E, "The effects of HIV on the sensitivity of a whole blood IFNgamma release assay in Zambian adults with active tuberculosis" 3 : e2489-, 2008

6 Ayubi E, "The clinical usefulness of tuberculin skin test versus interferon-gamma release assays for diagnosis of latent tuberculosis in HIV patients: a meta-analysis" 11 : e0161983-, 2016

7 "Targeted tuberculin testing and treatment of latent tuberculosis infection. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. This is a Joint Statement of the American Thoracic Society (ATS) and the Centers for Disease Control and Prevention (CDC). This statement was endorsed by the Council of the Infectious Diseases Society of America. (IDSA), September 1999, and the sections of this statement" 161 (161): S221-S247, 2000

8 Dheda K, "T-cell interferongamma release assays for the rapid immunodiagnosis of tuberculosis: clinical utility in high-burden vs. low-burden settings" 15 : 188-200, 2009

9 Pai M, "T-cell assays for the diagnosis of latent tuberculosis infection: moving the research agenda forward" 7 : 428-438, 2007

10 Ribeiro S, "T-SPOT.TB responses during treatment of pulmonary tuberculosis" 9 : 23-, 2009