RT Journal Article SR Electronic T1 Interferon-γ release assays for the diagnosis of latent M. tuberculosis infection: A systematic review and meta-analysis JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP erj01151-2010 DO 10.1183/09031936.00115110 A1 R. Diel A1 D. Goletti A1 G. Ferrara A1 G. Bothamley A1 D. Cirillo A1 B. Kampmann A1 C. Lange A1 M. Losi A1 R. Markova A1 G.B. Migliori A1 A. Nienhaus A1 M. Ruhwald A1 D. Wagner A1 J.P. Zellweger A1 E. Huitric A1 A. Sandgren A1 D. Manissero YR 2010 UL http://erj.ersjournals.com/content/early/2010/10/28/09031936.00115110.abstract AB We conducted a systematic review and meta-analysis to compare the accuracy of the QuantiFERON-TB Gold In-Tube (QFT-G-IT) and the T-SPOT.TB assays with the tuberculin skin test (TST) for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI).Medline, EMBASE and Cochrane databases were explored for relevant articles through November 2009. Specificities, negative (NPV) and positive (PPV) predictive values of interferon-γ release assays (IGRAs) and the TST and the exposure gradient influences on test results among bacillus-Calmette-Guérin (BCG) vaccinees were evaluated.Specificity of IGRAs varied from 98%–100%. In non-immunocompromized adults, NPV for progression to tuberculosis within 2 years were 97.8% for T-SPOT.TB and 99.8% for QFT-G-IT, respectively. When test performance of an immunodiagnostic test was not restricted to prior positivity of another test, progression rates to tuberculosis among IGRA-positive individuals followed for 19–24 months varied between 8–15%, exceeding those reported for the TST (2–3%). In multivariate analyses, the odd ratios for TST positivity following BCG vaccination varied from 3–25, whereas IGRA results remained uninfluenced and IGRA positivity was clearly associated with exposure to contagious tuberculosis cases.IGRAs may have a relative advantage over the TST in detecting LTBI and allow the exclusion of M. tuberculosis infection with higher reliability.