Connell Tom G, Rangaka Molebogeng X, Curtis Nigel, Wilkinson Robert J
Department of Pediatrics, University of Melbourne, Australia.
Expert Rev Mol Diagn. 2006 Sep;6(5):663-77. doi: 10.1586/14737159.6.5.663.
Tuberculosis (TB) remains a major threat to global health. The recently launched Global Plan to Stop Tuberculosis 2006-2015 highlights the need for accurate, simple and low-cost diagnostic tests for the detection of TB infection. For the first time in decades, new diagnostic tools have emerged that may facilitate this goal. The discovery of Mycobacterium tuberculosis-specific immunodominant antigens has led to the development of interferon gamma-release assays that have been shown to have high sensitivity and specificity for TB disease. This review focuses on the QuantiFERON-TB Gold tests and addresses the potential strengths and limitations of the current assays, summarizes the available evidence for their use and identifies areas of future research and development. Although representing an advance in TB diagnostics, with the potential to have a significant impact on global TB control, many issues remain unanswered. The cost of the tests and laboratory requirements may limit their use in developing countries. Most importantly, additional studies are needed in TB-endemic regions, particularly in high-risk persons such as children and individuals who are also co-infected with HIV.
结核病仍然是全球健康的重大威胁。最近发起的《2006 - 2015年全球遏制结核病计划》强调，需要有准确、简单且低成本的诊断检测方法来检测结核感染。几十年来首次出现了可能有助于实现这一目标的新诊断工具。结核分枝杆菌特异性免疫显性抗原的发现促使了γ-干扰素释放检测法的发展，该检测法已被证明对结核病具有高敏感性和特异性。本综述聚焦于结核感染T细胞检测（QFT - TB Gold）试验，探讨了当前检测方法的潜在优势和局限性，总结了其应用的现有证据，并确定了未来研发的领域。尽管这代表了结核病诊断方面的一项进展，有可能对全球结核病控制产生重大影响，但许多问题仍未得到解答。检测成本和实验室要求可能会限制其在发展中国家的使用。最重要的是，结核病流行地区，特别是儿童和同时感染艾滋病毒的高危人群等，还需要进行更多研究。
