title: Improving the diagnosis of tuberculosis: From QuantiFERON to new techniques to diagnose tuberculosis infections.
abstract: The diagnosis of latent and active tuberculosis in the HIV-positive population is challenged by diminished sensitivity of conventional tests, atypical presentations, and the lack of culture methods in the developing world, where the burden of co-infection is greatest. In response to these challenges, a variety of new diagnostics have emerged. These include interferon-gamma release assays for the diagnosis of latent tuberculosis (TB) infection and novel culture methods and molecular assays for the diagnosis of active tuberculosis. Although some tests (such as interferon-gamma release assays) are not clearly superior to existing diagnostics, other novel diagnostics, such as real-time polymerase chain reaction and the microscopic observed direct susceptibility assay hold much promise for prompt and accurate TB diagnosis in this population. Line-probe, nitrate reductase, and mycobacteriophage assays have also provided rapid alternatives to conventional time-consuming drug susceptibility testing and are critical to curtailing the spread of multidrug-resistant TB.
authors.affiliation: Infectious Disease, University of Pennsylvania, Philadelphia, USA. amy.vittor@uphs.upenn.edu
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Vittor
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Garland
authors.forename: David
authors.initials: D
authors.lastname: Schlossberg
mesh_terms: D006678:HIV; D015658:HIV Infections / Q000382:microbiology*; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods / Q000592:standards; D014374:Tuberculin Test / Q000379:methods / Q000592:standards; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology / Q000821:virology*