Domínguez José, Latorre Irene, Santin Miguel
Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona. CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III , Badalona, Barcelona, España.
Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge, IDIBELL, Departamento de Ciencias Clínicas, Universidad de Barcelona, Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III , L'Hospitalet de Llobregat, Barcelona, España.
Enferm Infecc Microbiol Clin (Engl Ed). 2018 May;36(5):302-311. doi: 10.1016/j.eimc.2017.11.014. Epub 2017 Dec 31.
Detection and treatment of latent tuberculosis infection (LTBI) is an essential measure for tuberculosis (TB) control in low-incidence countries. However, such strategy is limited by the low predictive ability of the diagnostic tests for the development of active TB among infected people and the long-term and toxic treatment regimens. The in vitro interferon-gamma release assays are more specific and sensitive than the tuberculin skin test (TST), and enable a better selection of cases requiring treatment. Nonetheless, their capacity to predict development of TB is still poor. In addition, treatment regimens for LTBI are long, and compliance rates are low. This review discusses the use of the available diagnostic tests and the new approaches to the diagnosis of LTBI, as well as its management in different clinical scenarios.
潜伏性结核感染（LTBI）的检测与治疗是低发病率国家结核病（TB）控制的一项重要措施。然而，该策略受到诊断检测对感染者发生活动性结核病预测能力低以及长期且有毒性的治疗方案的限制。体外干扰素-γ释放试验比结核菌素皮肤试验（TST）更具特异性和敏感性，能够更好地选择需要治疗的病例。尽管如此，它们预测结核病发生的能力仍然较差。此外，LTBI的治疗方案疗程长，依从率低。本综述讨论了现有诊断检测的应用以及LTBI诊断的新方法，以及其在不同临床场景中的管理。
