Servei de Microbiologia, Fundació Institut d'Investigació en Ciències de la Salut 'Germans Trias i Pujol', Carretera del Canyet s/n, 08916 Badalona, Barcelona, Spain and, Universitat Autònoma de Barcelona, Bellaterra, Spain and, CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Barcelona, Spain.
Expert Rev Respir Med. 2009 Jun;3(3):309-27. doi: 10.1586/ers.09.20.
The tuberculin skin test (TST) is used for diagnosing latent TB infection (LTBI). The main limitation of TST is its low sensitivity in populations with the highest risk of progression to active TB: immunosuppressed patients and young children. New IFN-gamma-based tests appear as an alternative to the TST. IFN-gamma-based tests seem more specific than the TST, being closely associated with LTBI factors, and not being affected by bacillus Calmette-Guérin vaccination. Indeterminate results are mainly related to immunosuppression. Looking at the available data, it seems prudent to recommend the utilization of IFN-gamma-based tests after a negative TST result, in order to increase the sensitivity of detecting LTBI cases in severely immunosuppressed patients. In summary, IFN-gamma-based tests appear to be a valuable tool, in combination with the TST, for diagnosing TB infection in immunosuppressed patients.
结核菌素皮肤试验（TST）用于诊断潜伏性结核感染（LTBI）。TST 的主要局限性在于其在进展为活动性结核病风险最高的人群中的敏感性较低：免疫抑制患者和幼儿。新型 IFN-γ 检测方法似乎是 TST 的替代方法。IFN-γ 检测方法似乎比 TST 更具特异性，与 LTBI 因素密切相关，不受卡介苗接种的影响。不确定结果主要与免疫抑制有关。从现有数据来看，建议在 TST 结果为阴性后使用 IFN-γ 检测方法，以提高严重免疫抑制患者 LTBI 病例的检测灵敏度，这似乎是谨慎的做法。总之，IFN-γ 检测方法似乎是一种有价值的工具，与 TST 结合使用可用于诊断免疫抑制患者的结核感染。
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