Diagnosis of latent Mycobacterium tuberculosis infection: is the demise of the Mantoux test imminent?

@article{Rothel2005DiagnosisOL,
  title={Diagnosis of latent Mycobacterium tuberculosis infection: is the demise of the Mantoux test imminent?},
  author={J. S. Rothel and Peter Andersen},
  journal={Expert Review of Anti-infective Therapy},
  year={2005},
  volume={3},
  pages={981 - 993}
}
  • J. Rothel, P. Andersen
  • Published 1 December 2005
  • Medicine, Biology
  • Expert Review of Anti-infective Therapy
Tuberculosis is responsible for more then 2 million deaths worldwide each year and vies with HIV as the world’s most fatal infectious disease. In many developing countries, attempts to control the spread of infection rely solely on identification and treatment of those with active disease, ignoring subclinical infection. However, in developed countries, large efforts are also expended to identify and give prophylactic drugs to people with latent tuberculosis infection. Until recently, the 100… 
Tuberculin skin test: review article
can spread among people by infected droplets. So identifying and treating people with latent TB infection can significantly reduce the progression of latent form to active infection. The tuberculin
New tools and emerging technologies for the diagnosis of tuberculosis: Part I. Latent tuberculosis
TLDR
Due to its high specificity, in vitro T-cell-based interferon-γ release assays may be useful in low-endemic, high-income settings where cross-reactivity due to BCG might adversely impact the utility of TST.
Latent tuberculosis: which test in which situation?
TLDR
The main advantage of the new tests is the absence of interference with BCG and non-tuberculous mycobacteria, which confers high specificity on the test, which allows a more selective choice of persons for whom preventive treatment is indicated.
Diagnosing Latent Tuberculosis Infection in the HIV Era
Tuberculin skin testing (TST) and Interferon-gamma (IFNγ)release assays (IGRAs) are presently the only available assays for the detection of Mycobacterium tuberculosis infected individuals. IGRAs
A Dynamic Reinfection Hypothesis of Latent Tuberculosis Infection
TLDR
A dynamic scenario of constant endogenous reinfection with M. tuberculosis is proposed which explains the efficacy of the current standard of treatment and new strategies for the management of TB may arise.
Latent tuberculosis infection treatment and T-cell responses to Mycobacterium tuberculosis-specific antigens.
TLDR
LTBI treatment had a differential effect on T-cell responses to ESAT-6 and CFP-10 as measured by the T-SPOT.TB, which suggests the quantitative response to C FP-10 may be a useful LTBI treatment-monitoring tool.
Evaluation of Mycobacterium tuberculosis--specific antibody responses in populations with different levels of exposure from Tanzania, Ethiopia, Brazil, and Denmark.
  • S. Hoff, M. Abebe, K. Weldingh
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2007
TLDR
This study confirms the presence of ESAT-6 and CFP-10 antibodies in patients with TB, and demonstrates that significant antibody responses are not restricted to active TB disease but can reflect latent infection, particularly in areas with high levels of exposure to M. tuberculosis.
Comparison of Screening Procedures for Mycobacterium tuberculosis Infection Among Patients with Inflammatory Diseases
TLDR
A positive QFT was more closely associated with risk factors for M. tuberculosis infection than the TST, and the use of corticosteroids affected test outcome by increasing the risk for an inconclusive QFT result and decreasing therisk for a positive TST result.
Avoiding the effect of BCG vaccination in detecting Mycobacterium tuberculosis infection with a blood test
TLDR
In bacille Calmette–Guérin-vaccinated individuals, the Mycobacterium tuberculosis-specific enzyme-linked immunospot assay is a better indicator for the risk of latent tuberculosis infection than the tuberculin skin test.
...
...

References

SHOWING 1-10 OF 82 REFERENCES
Early Diagnosis of Subclinical Multidrug-Resistant Tuberculosis
TLDR
What is believed to be the first clinical application of the ELISPOT assay to an important and difficult problem: the evaluation of a person receiving immunosuppressive therapy who was recently exposed to tuberculosis.
Specific Detection of Tuberculosis Infection: An Interferon-γ–based Assay Using New Antigens
The tuberculin skin test for immunologic diagnosis of Mycobacterium tuberculosis infection has many limitations, including being confounded by bacillus Calmette-Guerin (BCG) vaccination or exposure
Utility of the antigen-specific interferon-γ assay for the management of tuberculosis
TLDR
Compared with the tuberculin skin test, the antigen-specific interferon-γ assay, when used in a standardised protocol for the diagnosis of LTBI, has greater specificity in BCG-vaccinated individuals, displays a stronger association with exposure, and is less biased by environmental mycobacteria such as Mycobacterium avium.
Comparison of tuberculin skin test and new specific blood test in tuberculosis contacts.
TLDR
The QTF-TB test addresses the operational problems with the tuberculin skin test, but it still has a low specificity in populations vaccinated with the Bacille Calmette-Guérin (BCG) vaccine.
Rapid detection of active and latent tuberculosis infection in HIV-positive individuals by enumeration of Mycobacterium tuberculosis-specific T cells
TLDR
The ELISPOT assay is more specific, and possibly more sensitive, than PPD-based methods of detecting latent M. tuberculosis infection, and may potentially improve the targeting of isoniazid preventative therapy to HIV-positive individuals with latent tuberculosis infection.
Rapid detection of Mycobacterium tuberculosis infection by enumeration of antigen-specific T cells.
TLDR
This approach enables rapid detection of M. tuberculosis infection in patients with active tuberculosis and in exposed asymptomatic individuals at high risk of latent infection; it also successfully distinguishes between M.culosis infection and BCG vaccination.
Bacille Calmette-Guérin vaccinations and tuberculin skin tests.
TLDR
Tuberculin testing of persons from countries with high rates of tuberculosis is recommended, but many of these persons have a history of vaccination with bacille Calmette-Guerin, which makes the interpretation of tuberculin skin tests more difficult.
Tuberculin Skin Testing Compared with T-Cell Responses to Mycobacterium tuberculosis-Specific and Nonspecific Antigens for Detection of Latent Infection in Persons with Recent Tuberculosis Contact
TLDR
The specificity of the TST or in vitro responses to PPD will be even less when the proportion of BCG-vaccinated persons among TB contacts evaluated for LTBI increases.
...
...