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IGRA TB tests expected to significantly reduce false-positive results compared with TST

NEW YORK — Jeffrey R. Starke, MD, an Infectious Diseases in Children Editorial Board member, addresses the growing availability of interferon-gamma release assays over traditionally used tuberculin skin test in children who are at high risk for tuberculosis.

As there is no established ‘gold standard’ for diagnosis of latent tuberculosis infection, both the tuberculin skin test and IGRAs can be used for diagnosis. However, Starke noted that the two commercially available IGRAs – QuantiFERON-TB Gold In Tube and T-SPOT.TB – were more specific than the TST for children who were immunized with Bacillus Calmette-Guérin vaccine and at intermediate risk for TB infection.  

While the IGRAs have demonstrated comparable test sensitivity to TST, Starke mentioned that there is sparse data for children aged younger than two years who are at increased risk of developing disease if they have infection.

“The bottom line for these tests is that for children aged 5 years and above, these blood tests can be substituted anytime you would use a tuberculin skin test,” Starke told Infectious Diseases in Children.