COMPARISON OF NEW AND OLD TESTS FOR THE DIAGNOSIS OF LATENT TUBERCULOSIS INFECTION (QuantiFERON and TST)
Autori:
Dubravka Majić Milotić, Sanja Popović-Grle, Vera Katalinić-Janković, Aleksandar Šimunović
Sažetak
Tuberkuloza (TBC) druga je najčešća zarazna bolest na svijetu, uzrokovana bacilom Mycobacterium tuberculosis. Uz rijetku laringalnu, plućna tuberkuloza jedini je zarazni oblik bolesti, iako može zahvatiti bilo koji organ ljudskog tijela. Tuberkuloza je ponovni izazov liječnicima, jer se javlja uz brojne kronične bolesti i imunokompromitirana stanja, u starijoj životnoj dobi i jer neprikladno liječenje može dovesti do pojave rezistentnih oblika tuberkuloze. Stoga je dobra rana dijagnostika bolesti ključna za sve programe sprječavanja i suzbijanja tuberkuloze. Prije nego što je QuantiFERON odobren 2001. godine, tuberkulinski kožni test (PPD) bio je jedini test za otkrivanje latentne tuberkuloze. Za razliku od PPD-a, koji je test in vivo, postoje novi krvni testoviin vitro, tzv. IGRA-testovi (QuantiFERON i EliSPOT.TB). U radu su prezentirane prednosti i nedostaci obiju metoda, a pokazalo se da IGRA-testovi u odnosu prema PPD-u imaju višu specifičnost i osjetljivost.
Summary
Tuberculosis (TB) is the second most common contagious disease, caused by Mycobacterium tuberculosis (M. tuberculosis). Besides a rare laryngeal tuberculosis, pulmonary tuberculosis is the only one contagious form of the disease, although it can affect any organ of the human body. TB represents a new challenge to the doctors because it appears with numerous chronic diseases, affects immunocompromised hosts, elderly people and because nonadequate therapy could create drug resistant tuberculosis. Early diagnosis of TB is fundamental for every tuberculosis control program. Before 2001 when QuantiFERON test was approved, tuberculin skin test (TST) was the only diagnostic test for detection of latent M. tuberculosis infection. In contrast of TST, which is in vivo test, the novel whole blood tests in vitro, so-called IGRA tests (QuantiFERON, Elispot.T-SPOT.TB) now exist. This paper presents advantages and disadvantages of both methods. IGRA tests are considered to have higher specifity and sensitivity than TST.
