Authors: Rothel, James S; Andersen, Peter

Source: Expert Review of Anti-Infective Therapy, Volume 3, Number 6, December 2005 , pp. 981-993(13)

Publisher: Expert Reviews

Abstract:

Tuberculosis is responsible for more then 2 million deaths worldwide each year and vies with HIV as the world's most fatal infectious disease. In many developing countries, attempts to control the spread of infection rely solely on identification and treatment of those with active disease, ignoring subclinical infection. However, in developed countries, large efforts are also expended to identify and give prophylactic drugs to people with latent tuberculosis infection. Until recently, the 100-year-old tuberculin skin test (Mantoux) has been the only available diagnostic test for latent tuberculosis infection, despite its many well-known limitations. Advances in scientific knowledge have led to the development of tests for tuberculosis that measure the production of interferon-γ by T-cells stimulated in vitro with Mycobacterium tuberculosis-specific antigens. These interferon-γ tests are highly specific and unaffected by prior Bacille Calmette-Guérin vaccination or immune reactivity to most atypical mycobacteria. They are more sensitive than the tuberculin skin test in detecting people with active tuberculosis, and their results correlate more closely with M. tuberculosis exposure risk factors than the tuberculin skin test in people likely to have latent tuberculosis infection. Science has caught up with one of the oldest diagnostic tests still in use worldwide, and the adoption of new, tuberculosis-specific interferon-γ-based tests should move us one step closer to better control of this insidious pathogen.

Keywords: CFP-10; diagnosis; ESAT-6; interferon-γ; Mantoux; Mycobacterium tuberculosis; TST; tuberculosis

Document Type: Research article

DOI: http://dx.doi.org/10.1586/14787210.3.6.981

Publication date: 2005-12-01

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• Expert Review of Anti-infective Therapy provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.
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