Assay | Modality | Antigen/s | Pathogenetic principle | Diagnostic features and progression to TB | Visits n | Reading h | Diagnostic pitfalls |
TST | In vivo | Tuberculin (combination of mycobacterial proteins obtained from the supernatant of M. tuberculosis culture | Identification of a cellular immune response after the intra-dermal inoculation of tuberculin | PPV 0.024 NPV 0.994 | 2 | 48–72 | Decreased sensitivity: |
Immunocompromised individuals | |||||||
Recent viral infections; | |||||||
Recent M. Tuberculosis infection | |||||||
Recent immunisation with live vaccines; | |||||||
Individuals aged <6 months; | |||||||
Inadequate management of tuberculin | |||||||
Decreased specificity | |||||||
BCG vaccination; | |||||||
Exposure to non-tuberculous mycobacteria | |||||||
Decreased positive predictive value | |||||||
Low TB incidence areas. | |||||||
IGRA | Ex vivo | ESAT-6 CFP-10 TB7.7 | Identification of the production of IFN-γ after exposure of lymphocytes to mycobacterial antigens | PPV 0.068 NPV 0.997 | 1 | 6–20 | Indeterminate result |
ELISA | No increase, in children; | ||||||
ELISPOT | No Increase, in immunocompromised individuals |
TST: tuberculin skin test; IGRA: interferon (IFN)-γ release assay; ELISA: Enzyme-linked immunosorbent assay; M. tuberculosis: Mycobacterium tuberculosis; BCG: bacille Calmette–Guerin; ELISPOT: enzyme-linked immunosorbent spot assay; PPV: positive-predictive value; NPV: negative-predictive value ESAT-6: early secretory antigen target 6; CFP-10: culture filtrate protein 10.