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Over the past decade, tumour necrosis factor (<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>) antagonist has revolutionized the treatment of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>. However, the subsequent increased risk of developing tuberculosis is one of the major drawbacks of this otherwise effective treatment. Latent tuberculosis infection (<jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content>) is an asymptomatic form of tuberculosis that is confined by the host's immune system. Active tuberculosis may develop when the immune status weakens. This risk is much higher in patients receiving <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> antagonist. Traditionally, tuberculin skin test (<jats:styled-content style=\"fixed-case\">TST<\/jats:styled-content>) is used to diagnose <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content>. Unfortunately, <jats:styled-content style=\"fixed-case\">TST<\/jats:styled-content> cannot distinguish bacillus <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>almette\u2010<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>u\u00e9rin (<jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content>) vaccination from tuberculosis making it difficult to use as a reliable diagnostic tool. In addition, possible anergy and interaction of the altered autoimmune status in rheumatological diseases further complicate the interpretation of <jats:styled-content style=\"fixed-case\">TST<\/jats:styled-content> results. Although interferon\u2010gamma release assay (<jats:styled-content style=\"fixed-case\">IGRA<\/jats:styled-content>) has improved the diagnosis of <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content> in immunocompetent individuals, its respective sensitivity\/specificity values are unknown in patients with autoimmune disease due to variable pretest probability and lack of confirmatory test for <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content>. Thus, the use of <jats:styled-content style=\"fixed-case\">IGRA<\/jats:styled-content> for screening <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content> is variable among different countries. This review explores the prevalence of tuberculosis in patients receiving <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> antagonist in countries with different tuberculosis disease burdens and the potential mechanisms for variation in the incidence of tuberculosis with different <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> antagonists, the current practice guidelines for assessing the risk of <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content> in different countries, and the possible solutions for improving diagnosis, monitoring and management of <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/resp.12106","type":"journal-article","created":{"date-parts":[[2013,4,30]],"date-time":"2013-04-30T07:25:38Z","timestamp":1367306738000},"page":"765-773","source":"Crossref","is-referenced-by-count":11,"title":["Tumour necrosis factor antagonist and tuberculosis in patients with rheumatoid arthritis: An <scp>A<\/scp>sian perspective"],"prefix":"10.1111","volume":"18","author":[{"given":"Kin Wang","family":"To","sequence":"first","affiliation":[{"name":"Division of Respiratory Medicine Prince of Wales Hospital, The Chinese University of Hong Kong  Hong Kong, SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan J Gomez","family":"Reino","sequence":"additional","affiliation":[{"name":"Department of Medicine and Rheumatology Unit Hospital Cl\u00ednico Universitario, USC  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae Hyun","family":"Yoo","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine Hanyang University Hospital, Hanyang University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai Shan","family":"Tam","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Medicine and Therapeutics Prince of Wales Hospital, The Chinese University of Hong Kong  Hong Kong, SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780361206"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2011.278"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11137"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20009"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21137"},{"key":"e_1_2_8_7_1","first-page":"706","article-title":"Incidence of tuberculosis in Korean patients with rheumatoid arthritis (RA): effects of RA itself and of tumor necrosis factor blockers","volume":"34","author":"Seong SS","year":"2007","journal-title":"J. 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