Interferon-¿ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis

M Sester; G Sotgiu; C Lange; C Giehl; E Girardi; G B Migliori; A Bossink; K Dheda; R Diel; J Dominguez; M Lipman; J Nemeth; P Ravn; S Winkler; E Huitric; A Sandgren; D Manissero

doi:10.1183/09031936.00114810

Interferon-¿ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis

M Sester, G Sotgiu, C Lange, C Giehl, E Girardi, G B Migliori, A Bossink, K Dheda, R Diel, J Dominguez, M Lipman, J Nemeth, P Ravn, S Winkler, E Huitric, A Sandgren, D Manissero

406 Citations (Scopus)

Abstract

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. Copyright

Original language	English
Journal	European Respiratory Journal
Volume	37
Issue number	1
Pages (from-to)	100-111
Number of pages	12
ISSN	0903-1936
DOIs	https://doi.org/10.1183/09031936.00114810
Publication status	Published - 1 Jan 2011

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Sester, M., Sotgiu, G., Lange, C., Giehl, C., Girardi, E., Migliori, G. B., Bossink, A., Dheda, K., Diel, R., Dominguez, J., Lipman, M., Nemeth, J., Ravn, P., Winkler, S., Huitric, E., Sandgren, A., & Manissero, D. (2011). Interferon-¿ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis. European Respiratory Journal, 37(1), 100-111. https://doi.org/10.1183/09031936.00114810

Sester, M, Sotgiu, G, Lange, C, Giehl, C, Girardi, E, Migliori, GB, Bossink, A, Dheda, K, Diel, R, Dominguez, J, Lipman, M, Nemeth, J, Ravn, P, Winkler, S, Huitric, E, Sandgren, A & Manissero, D 2011, 'Interferon-¿ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis', European Respiratory Journal, vol. 37, no. 1, pp. 100-111. https://doi.org/10.1183/09031936.00114810

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title = "Interferon-¿ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis",

abstract = "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{\textregistered} Gold in-tube (QFT-G-IT) and T-SPOT.TB{\textregistered} 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{\textregistered}, 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{\textregistered}, 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. Copyright",

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T1 - Interferon-¿ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis

AU - Sester, M

AU - Sotgiu, G

AU - Lange, C

AU - Giehl, C

AU - Girardi, E

AU - Migliori, G B

AU - Bossink, A

AU - Dheda, K

AU - Diel, R

AU - Dominguez, J

AU - Lipman, M

AU - Nemeth, J

AU - Ravn, P

AU - Winkler, S

AU - Huitric, E

AU - Sandgren, A

AU - Manissero, D

PY - 2011/1/1

Y1 - 2011/1/1

N2 - 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. Copyright

AB - 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. Copyright

U2 - 10.1183/09031936.00114810

DO - 10.1183/09031936.00114810

M3 - Journal article

C2 - 20847080

SN - 0904-1850

VL - 37

SP - 100

EP - 111

JO - Acta tuberculosea Scandinavica

JF - Acta tuberculosea Scandinavica

IS - 1

ER -

Interferon-¿ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis

Abstract

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