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<p>The approach to the diagnostics of a&#xa0;latent infection with <i>Mycobacterium tuberculosis</i> has evolved in recent years. Interferon-gamma release assays (IGRA) have largely replaced the traditional tuberculin skin test (TST) and are now recommended as the preferred method for identifying individuals with a&#xa0;latent infection. The IGRA provides higher specificity, particularly in BCG-vaccinated individuals and the performance and interpretation are easier than for TST. The appropriate indications for IGRA testing are essential in the clinical practice. Screening and preventive chemotherapy in cases of a positive IGRA test are recommended for all individuals at increased risk of progression to active tuberculosis. Risk groups include close contacts of patients with pulmonary tuberculosis, migrants from countries with a high incidence of tuberculosis, persons with HIV and uncontrolled HIV replication and patients before receiving planned tumor necrosis factor alpha (TNF-α) antagonists or Janus kinase (JAK) inhibitors. Additional risk groups with conditional recommendations for IGRA testing include patients before organ or stem cell transplantation and individuals with chronic kidney disease on hemodialysis treatment. In such cases, the decision to test should take additional risk factors, the degree of immunosuppression and the total clinical context into account. The decision for performing IGRA should lead to the initiation of preventive chemotherapy in the case of a&#xa0;positive test result. Early identification and treatment of latent infections can help reduce the incidence of tuberculosis in high-risk groups and prevent outbreaks.</p>

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Evidenzbasierter Einsatz von Interferon-Gamma Release Assays in der Tuberkulosediagnostik

  • 期刊论文

  • 发表日期：

    2025年12月4日

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  • Raja Idris,
  • Rebecca Urschel,
  • Christoph Lange,
  • Martina Sester

摘要

The approach to the diagnostics of a latent infection with Mycobacterium tuberculosis has evolved in recent years. Interferon-gamma release assays (IGRA) have largely replaced the traditional tuberculin skin test (TST) and are now recommended as the preferred method for identifying individuals with a latent infection. The IGRA provides higher specificity, particularly in BCG-vaccinated individuals and the performance and interpretation are easier than for TST. The appropriate indications for IGRA testing are essential in the clinical practice. Screening and preventive chemotherapy in cases of a positive IGRA test are recommended for all individuals at increased risk of progression to active tuberculosis. Risk groups include close contacts of patients with pulmonary tuberculosis, migrants from countries with a high incidence of tuberculosis, persons with HIV and uncontrolled HIV replication and patients before receiving planned tumor necrosis factor alpha (TNF-α) antagonists or Janus kinase (JAK) inhibitors. Additional risk groups with conditional recommendations for IGRA testing include patients before organ or stem cell transplantation and individuals with chronic kidney disease on hemodialysis treatment. In such cases, the decision to test should take additional risk factors, the degree of immunosuppression and the total clinical context into account. The decision for performing IGRA should lead to the initiation of preventive chemotherapy in the case of a positive test result. Early identification and treatment of latent infections can help reduce the incidence of tuberculosis in high-risk groups and prevent outbreaks.