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Interferon-Gamma Release Assays for the Diagnosis of Tuberculosis: A Systematic Review and Meta-analysis

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Abstract

Background and Objective

We conducted a systematic review and meta-analysis to compare the accuracy of the interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST) for the diagnosis of Mycobacterium tuberculosis infection.

Methods

We systematically searched PubMed, Embase, Cochrane library, and Web of Science databases for relevant published studies in recent decades and calculated pooled estimated sensitivities, specificities, DOR, and SROC curve of the QFT-IT, T-SPOT and TST. Random-effects models were used to assess estimates from studies with significant heterogeneity. Moreover, area under the curve was used to evaluate the accuracy of the tests.

Results

Overall, 9 studies for QFT-IT, 12 studies for T-SPOT, and 16 studies for TST involving 3586 participants were included in this analysis. We found that sensitivities of the QFT-IT, T-SPOT, and TST were respectively 0.842 (95 % CI 0.811–0.870), 0.840 (95 % CI 0.814–0.864), and 0.665 (CI 0.635–0.693); specificities were respectively 0.745 (95 % CI 0.715–0.775), 0.658 (95 % CI 0.621–0.693), and 0.633 (CI 0.605–0.661); positive likelihood ratios were respectively 3.652 (95 % CI 2.180–6.117), 2.196 (95 % CI 1.727–2.794), and 1.825 (95 % CI 1.351–2.464); negative likelihood ratios were respectively 0.212 (95 % CI 0.109–0.414), 0.246 (95 % CI 0.161–0.377), and 0.556 (95 % CI 0.385–0.804); the SROC curves were 19.205, 10.397, and 3.810.

Conclusions

The two IGRAs showed better performance than TST for the diagnosis of the tuberculosis. However, neither of them showed stability in the diagnosis of TB.

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Abbreviations

TB:

Tuberculosis

TST:

Tuberculin skin test

BCG:

Bacille Calmette–Gue´rin

IGRAs:

Interferon (IFN)-γ release assays

QFT-IT:

Quantiferon-TB gold in-tube test

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Acknowledgments

We thank Li-mei Zhu M.D. for her discussion and help.

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    Authors and Affiliations

    1. School of Public Health, Nanjing Medical University, Longmiandadao 101, Nanjing, 211166, China

      Peng Lu

    2. The Fourth Clinical School of Nanjing Medical University, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China

      Xiu Chen

    3. Department of Chronic Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention Affiliated to Nanjing Medical University, Jiangsulu 172, Nanjing, 210009, China

      Peng Lu & Li-mei Zhu

    4. Jiangsu Institute of Parasitic Diseases, Yangxiang 117, Wuxi, 214064, China

      Hai-tao Yang

    5. Nanjing Medical University, Longmiandadao 101, Nanjing, 211166, China

      Hai-tao Yang

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    Correspondence to Hai-tao Yang.

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    Peng Lu and Xiu Chen have contributed equally to this study.

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    Lu, P., Chen, X., Zhu, Lm. et al. Interferon-Gamma Release Assays for the Diagnosis of Tuberculosis: A Systematic Review and Meta-analysis. Lung 194, 447–458 (2016). https://doi.org/10.1007/s00408-016-9872-5

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    • DOI: https://doi.org/10.1007/s00408-016-9872-5

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