干扰素-γ释放试验和结核菌素皮肤试验检测潜伏性结核感染的阳性率：一项对200,000项直接比较试验的系统评价和荟萃分析。

Positive rates of interferon-γ release assay and tuberculin skin test in detection of latent tuberculosis infection: A systematic review and meta-analysis of 200,000 head-to-head comparative tests.

作者信息

Zhou Guozhong, Luo Qingyi, Luo Shiqi, He Jian, Chen Nan, Zhang Yu, Yang Rui, Qiu Yubing, Li Shenghao, Ping Qinrong, Cai Shunli, Guo Xin, Song Chao

机构信息

Department of Science and Research, The First People's Hospital of Anning Affiliated to Kunming University of Science and Technology, Kunming, Yunnan Province 650302, China.

Department of Medical Imaging, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan Province 650051, China.

出版信息

Clin Immunol. 2022 Dec;245:109132. doi: 10.1016/j.clim.2022.109132. Epub 2022 Sep 30.

DOI:10.1016/j.clim.2022.109132

PMID:36184056

Abstract

OBJECTIVE

To compare the positive rates of IGRA and TST in detection of LTBI.

METHODS

We searched PubMed, Embase, and the Cochrane Library on March 12, 2022. A random-effects model was used to calculate pooled results.

RESULTS

We included 458 head-to-head studies. Compared with immunocompetent controls, TST positive rate in immunosuppressed population decreased more than IGRA positive rate (OR 0.36 [95% CI: 0.31 to 0.41] versus 0.53 [0.46 to 0.61]). In immunocompetent BCG-vaccinated individuals, IGRA positive rate in low-TB burden areas was significantly lower than TST positive rate, but the difference was decreased in high-TB burden areas (OR 0.75 [0.60 to 0.94]). Additionally, IGRA positive rate was equal to that of TST in the elderly (OR 0.98 [0.66 to 1.46]).

CONCLUSION

TST is more susceptible to immunosuppression than IGRA. The effect of BCG on TST might be weakened in high-TB burden areas, and TST response waned in the elderly.

REVIEW REGISTRATION

PROSPERO CRD42020180163.

摘要

目的

比较IGRA和TST检测潜伏性结核感染（LTBI）的阳性率。

方法

于2022年3月12日检索了PubMed、Embase和Cochrane图书馆。采用随机效应模型计算汇总结果。

结果

我们纳入了458项直接比较的研究。与免疫功能正常的对照组相比，免疫抑制人群中TST阳性率的下降幅度大于IGRA阳性率（比值比[OR]0.36[95%置信区间（CI）：0.31至0.41]对0.53[0.46至0.61]）。在接种卡介苗的免疫功能正常个体中，低结核病负担地区IGRA阳性率显著低于TST阳性率，但在高结核病负担地区差异减小（OR 0.75[0.60至0.94]）。此外，老年人中IGRA阳性率与TST阳性率相当（OR 0.98[0.66至1.46]）。