TY - JOUR T1 - LTBI: latent tuberculosis infection or lasting immune responses to <em>M. tuberculosis</em>? A TBNET consensus statement JF - European Respiratory Journal JO - Eur Respir J SP - 956 LP - 973 DO - 10.1183/09031936.00120908 VL - 33 IS - 5 AU - U. Mack AU - G. B. Migliori AU - M. Sester AU - H. L. Rieder AU - S. Ehlers AU - D. Goletti AU - A. Bossink AU - K. Magdorf AU - C. Hölscher AU - B. Kampmann AU - S. M. Arend AU - A. Detjen AU - G. Bothamley AU - J. P. Zellweger AU - H. Milburn AU - R. Diel AU - P. Ravn AU - F. Cobelens AU - P. J. Cardona AU - B. Kan AU - I. Solovic AU - R. Duarte AU - D. M. Cirillo AU - C. Lange for the TBNET Y1 - 2009/05/01 UR - http://erj.ersjournals.com/content/33/5/956.abstract N2 - Tuberculosis control relies on the identification and preventive treatment of individuals who are latently infected with Mycobacterium tuberculosis. However, direct identification of latent tuberculosis infection is not possible. The diagnostic tests used to identify individuals latently infected with M. tuberculosis, the in vivo tuberculin skin test and the ex vivo interferon-γ release assays (IGRAs), are designed to identify an adaptive immune response against, but not necessarily a latent infection with, M. tuberculosis. The proportion of individuals who truly remain infected with M. tuberculosis after tuberculin skin test or IGRA conversion is unknown. It is also uncertain how long adaptive immune responses towards mycobacterial antigens persist in the absence of live mycobacteria. Clinical management and public healthcare policies for preventive chemotherapy against tuberculosis could be improved, if we were to gain a better understanding on M. tuberculosis latency and reactivation. This statement by the TBNET summarises knowledge and limitations of the currently available tests used in adults and children for the diagnosis of latent tuberculosis infection. In summary, the main issue regarding testing is to restrict it to those who are known to be at higher risk of developing tuberculosis and who are willing to accept preventive chemotherapy. ER -