From the authors:
We thank our colleagues for their comment on the TBNET consensus statement on the risk of tuberculosis (TB) related to tumour necrosis factor (TNF) antagonist therapies [1]. The authors correctly point to a persistent diagnostic dilemma: the diagnosis of “true” latent infection with Mycobacterium tuberculosis [2] and the lack of knowledge on the positive predictive value for the development of TB offered by the two currently available immunodiagnostic methods, the tuberculin skin test (TST) and interferon-γ release assays (IGRAs), in a variety of clinical circumstances [3].
By definition, the diagnosis of latent infection with M. tuberculosis relies on the presence of a positive M. tuberculosis-specific immune response in a TST or an IGRA. However, …