Comparison of two interferon-gamma release assays and tuberculin skin test for detecting latent tuberculosis in patients with immune-mediated inflammatory diseases.

摘要

Biological agents interfering with proinflammatory tumour necrosis factor a (TNFalpha) signalling have become an established tool in the treatment of rheumatoid arthritis and other chronic inflammatory conditions. Their use is associated with an increased risk for some infections including the reactivation of latent tuberculosis infection (LTBI). Consequently, screening for LTBI prior to onset of anti-TNFalpha therapy is recommended.Interferon gamma release assays (IGRAs) are novel diagnostic tools for the diagnosis of LTBI and show a high specificity compared with the tuberculin skin test (TST). However, optimal screening procedures are still a matter of debate. Furthermore, questions remain with regard to the performance of IGRAs in patients receiving immunosuppressive therapy and the comparative performance of the two commercially available IGRAs.