title: The use of interferon gamma release assays in the diagnosis of active tuberculosis.
abstract: Interferon gamma release assays (IGRAs) are in vitro immunologic diagnostic tests used to identify Mycobacterium tuberculosis infection. They cannot differentiate between latent and active infections. The cutoff suggested by the manufacturer is 0.35 IU/mL for latent tuberculosis. As IGRA tests were recently approved for the differential diagnosis of active tuberculosis, we assessed the diagnostic accuracy of the latest generation IGRA for detection of active tuberculosis in a low-incidence area in Germany. Our consecutive case series includes 61 HIV negative, Mycobacterium tuberculosis culture positive patients, as well as 234 control patients. The retrospective analysis was performed over a period of two years. In 11/61 patients with active tuberculosis (18.0%) the test result was <0.35 IU/mL, resulting in a sensitivity of 0.82. We recommend establishing a new cut-off value for the differential diagnosis of active tuberculosis assessed by prospective clinical studies and in various regions with high and low prevalence of tuberculosis.
authors.affiliation: Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, 14165 Berlin, Germany.
authors.forename: Silvan M
authors.initials: SM
authors.lastname: Vesenbeckh
authors.forename: Nicolas
authors.initials: N
authors.lastname: Schönfeld
authors.forename: Harald
authors.initials: H
authors.lastname: Mauch
authors.forename: Thorsten
authors.initials: T
authors.lastname: Bergmann
authors.forename: Sonja
authors.initials: S
authors.lastname: Wagner
authors.forename: Torsten T
authors.initials: TT
authors.lastname: Bauer
authors.forename: Holger
authors.initials: H
authors.lastname: Rüssmann