title: Guidelines for the use of interferon-γ release assays in the diagnosis of tuberculosis infection.
abstract: BACKGROUND
  Interferon-gamma release assays are widely used for the diagnosis of tuberculosis infection in low-prevalence countries. However, there is no consensus on their application. The objective of this study was to develop guidelines for the use of interferon-gamma release assays in specific clinical scenarios in Spain.
  
  
  METHODS
  A panel of experts comprising specialists in infectious diseases, respiratory diseases, microbiology, pediatrics and preventive medicine, together with a methodologist, formulated the clinical questions and outcomes of interest. They conducted a systematic literature search, summarized the evidence and rated its quality, and prepared the recommendations following the GRADE (Grading of Recommendations of Assessment Development and Evaluations) methodology.
  
  
  RESULTS
  The panel prepared recommendations on the use of interferon-gamma release assays for the diagnosis of tuberculosis infection in the contact-tracing study (both adults and children), health care workers, immunosuppressed patients (patients infected with human immunodeficiency virus, patients with chronic immunomediated inflammatory diseases due to start biological therapy and patients requiring organ transplant) and for the diagnosis of active tuberculosis. Most recommendations were weak, mainly due to the lack of good quality evidence to balance the clinical benefits and disadvantages of the interferon-gamma release assays as compared with the tuberculin skin test.
  
  
  CONCLUSIONS
  This document provides evidence-based guidance on the use of interferon-gamma release assays for the diagnosis of tuberculosis infection in patients at risk of tuberculosis or with suspicion of active disease. The guidelines will be applicable in specialist and primary care and in public health settings.
authors.affiliation: Service of Infectious Diseases, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Santin
authors.affiliation: Clinical Unit of Pneumology, Hospital San Agustín, Avilés, Asturias, Spain.
authors.forename: José-María
authors.initials: JM
authors.lastname: García-García
authors.affiliation: Service of Microbiology, Research Institute Trias i Pujol, Hospital Gremans Trias i Pujol, Barcelona, Spain; Department of Genetics and Microbiology, Universidad Autónoma de Barcelona, Barcelona, Spain; CIBER Respiratory Diseases, Madrid, Spain. Electronic address: jadomb@gmail.com.
authors.forename: José
authors.initials: J
authors.lastname: Domínguez
mesh_terms: D006801:Humans; D059425:Interferon-gamma Release Tests / Q000592:standards*; D017410:Practice Guidelines as Topic; D013030:Spain; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis*
keywords: Guideline; Guía de práctica clínica; Infección tuberculosa latente; Interferon-gamma release assays; Latent tuberculosis infection; Prevención; Prevention; Tuberculosis