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Diagnostic accuracy of interferon-gamma release assays for diagnosis of smear-negative pulmonary tuberculosis: a systematic review and meta-analysis.
Petnak, Tananchai; Eksombatchai, Dararat; Chesdachai, Supavit; Lertjitbanjong, Ploypin; Taweesedt, Pahnwat; Pornchai, Angsupat; Thongprayoon, Charat; Prokop, Larry J; Wang, Zhen.
Afiliación
  • Petnak T; Division of Pulmonary and Pulmonary Critical Care Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Ramathibodi Hospital, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.
  • Eksombatchai D; Division of Pulmonary and Pulmonary Critical Care Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Ramathibodi Hospital, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand. Dararat.eks@mahidol.ac.th.
  • Chesdachai S; Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
  • Lertjitbanjong P; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
  • Taweesedt P; Department of Pulmonary Medicine, Corpus Christi Medical Center, Corpus Christi, TX, USA.
  • Pornchai A; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
  • Thongprayoon C; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
  • Prokop LJ; Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA.
  • Wang Z; Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA.
BMC Pulm Med ; 22(1): 219, 2022 Jun 06.
Article en En | MEDLINE | ID: mdl-35668411
INTRODUCTION: The diagnosis of smear-negative pulmonary tuberculosis (SNPTB) is challenging. Interferon gamma-release assays (IGRAs) may be helpful in early diagnosis among these patients resulting in prompt treatment and favorable outcomes. METHODS: We performed a comprehensive search from each databases' inception to April 5, 2021. The studies that provided sufficient data regarding the sensitivity and specificity of IGRAs included QuantiFERON-TB Gold In-Tube (QFT-GIT), T-SPOT.TB, or QuantiFERON-TB Gold Plus for diagnosis of SNPTB were included. RESULTS: Of 1,312 studies screened, 16 studies were included; 11 QFT-GIT, 2 T-SPOT.TB, and 3 QFT-GIT and T-SPOT.TB. For diagnosis of SNPTB, QFT-GIT had sensitivity of 0.77 (95% CI 0.71-0.82), specificity of 0.70 (95% CI 0.58-0.80), diagnostic odds ratio (DOR) of 8.03 (95% CI 4.51-14.31), positive likelihood ratio (LR) of 2.61 (95% CI 1.80-3.80), negative LR of 0.33 (95% CI 0.25-0.42), and area under receiver operating characteristic (AUROC) of 0.81 (95% CI 0.77-0.84). T-SPOT.TB had sensitivity of 0.74 (95% CI 0.71-0.78), specificity of 0.71 (95% CI 0.49-0.86), DOR of 6.96 (95% CI 2.31-20.98), positive LR of 2.53 (95% CI 1.26-5.07), negative LR of 0.36 (95% CI 0.24-0.55), and AUROC of 0.77 (95% CI 0.73-0.80). The specificity seemed lower in the subgroup analyses of studies from high tuberculosis burden counties compared to the studies from low tuberculosis burden. CONCLUSION: IGRAs do have insufficient diagnostic performance for SNPTB. However, the tests are still helpful to exclude tuberculosis among patients with low pre-test probability. Registry: PROSPERO: CRD42021274653.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Tuberculosis Pulmonar Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies / Systematic_reviews Límite: Humans Idioma: En Revista: BMC Pulm Med Año: 2022 Tipo del documento: Article País de afiliación: Tailandia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Tuberculosis Pulmonar Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies / Systematic_reviews Límite: Humans Idioma: En Revista: BMC Pulm Med Año: 2022 Tipo del documento: Article País de afiliación: Tailandia Pais de publicación: Reino Unido