Improving the diagnosis of tuberculosis: from QuantiFERON to new techniques to diagnose tuberculosis infections
Vittor, A.Y.; Garland, J.M.; Schlossberg, D.
Current Hiv/Aids Reports 8(3): 153-163
2011
ISSN/ISBN: 1548-3576 PMID: 21660459 DOI: 10.1007/s11904-011-0083-7Document Number: 253938
The diagnosis of latent and active tuberculosis in the HIV-positive population is challenged by diminished sensitivity of conventional tests, atypical presentations, and the lack of culture methods in the developing world, where the burden of co-infection is greatest. In response to these challenges, a variety of new diagnostics have emerged. These include interferon-gamma release assays for the diagnosis of latent tuberculosis (TB) infection and novel culture methods and molecular assays for the diagnosis of active tuberculosis. Although some tests (such as interferon-gamma release assays) are not clearly superior to existing diagnostics, other novel diagnostics, such as real-time polymerase chain reaction and the microscopic observed direct susceptibility assay hold much promise for prompt and accurate TB diagnosis in this population. Line-probe, nitrate reductase, and mycobacteriophage assays have also provided rapid alternatives to conventional time-consuming drug susceptibility testing and are critical to curtailing the spread of multidrug-resistant TB.