Positive rates of interferon-γ release assay and tuberculin skin test in detection of latent tuberculosis infection: A systematic review and meta-analysis of 200,000 head-to-head comparative tests

Guozhong Zhou; Qingyi Luo; Shiqi Luo; Jian He; Nan Chen; Yu Zhang; Rui Yang; Yubing Qiu; Shenghao Li; Qinrong Ping; Shunli Cai; Xin Guo; Chao Song

doi:10.1016/j.clim.2022.109132

Positive rates of interferon-γ release assay and tuberculin skin test in detection of latent tuberculosis infection: A systematic review and meta-analysis of 200,000 head-to-head comparative tests

Clin Immunol. 2022 Dec:245:109132. doi: 10.1016/j.clim.2022.109132. Epub 2022 Sep 30.

Authors

Guozhong Zhou¹, Qingyi Luo², Shiqi Luo³, Jian He⁴, Nan Chen⁵, Yu Zhang⁵, Rui Yang⁶, Yubing Qiu⁶, Shenghao Li⁷, Qinrong Ping⁸, Shunli Cai⁹, Xin Guo⁹, Chao Song¹⁰

Affiliations

¹ Department of Science and Research, The First People's Hospital of Anning Affiliated to Kunming University of Science and Technology, Kunming, Yunnan Province 650302, China.
² Department of Medical Imaging, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan Province 650051, China.
³ State Key Laboratory of Medical Molecular Biology &Department of Immunology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.
⁴ Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Anning Affiliated to Kunming University of Science and Technology, Kunming, Yunnan Province 650302, China.
⁵ Department of Endocrinology, The First People's Hospital of Anning Affiliated to Kunming University of Science and Technology, Yunnan Province 650302, China.
⁶ Division of Tuberculosis Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan Province 650051, China.
⁷ Department of Hepatology 1, The Third People's Hospital of Kunming, Kunming 650500, China.
⁸ Department of Urology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan Province 650051, China.
⁹ School of Basic Medical Sciences, Kunming Medical University, Kunming, Yunnan Province 650051, China.
¹⁰ Department of Medical Imaging, The First People's Hospital of Anning Affiliated to Kunming University of Science and Technology, Kunming, Yunnan Province 650302, China. Electronic address: chaoge6870@163.com.

PMID: 36184056
DOI: 10.1016/j.clim.2022.109132

Abstract

Objective: To compare the positive rates of IGRA and TST in detection of LTBI.

Methods: We searched PubMed, Embase, and the Cochrane Library on March 12, 2022. A random-effects model was used to calculate pooled results.

Results: We included 458 head-to-head studies. Compared with immunocompetent controls, TST positive rate in immunosuppressed population decreased more than IGRA positive rate (OR 0.36 [95% CI: 0.31 to 0.41] versus 0.53 [0.46 to 0.61]). In immunocompetent BCG-vaccinated individuals, IGRA positive rate in low-TB burden areas was significantly lower than TST positive rate, but the difference was decreased in high-TB burden areas (OR 0.75 [0.60 to 0.94]). Additionally, IGRA positive rate was equal to that of TST in the elderly (OR 0.98 [0.66 to 1.46]).

Conclusion: TST is more susceptible to immunosuppression than IGRA. The effect of BCG on TST might be weakened in high-TB burden areas, and TST response waned in the elderly.

Review registration: PROSPERO CRD42020180163.

Keywords: Head-to-head comparison; Interferon-γ release assay; Latent tuberculosis infection; Positive rate; Tuberculin skin test.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Aged
BCG Vaccine
Humans
Immunocompromised Host
Interferon-gamma Release Tests* / methods
Latent Tuberculosis* / diagnosis
Tuberculin Test / methods

Substances

BCG Vaccine