{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:34:04Z","timestamp":1790890444484,"version":"4.1.0"},"reference-count":42,"publisher":"European Respiratory Society (ERS)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2011,2,7]]},"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:p>Although interferon-\u03b3 release assays (IGRAs) are intended for diagnosing latent tuberculosis (TB), we hypothesised that in a high-burden setting: 1) the magnitude of the response when using IGRAs can distinguish active TB from other diagnoses; 2) IGRAs may aid in the diagnosis of smear-negative TB; and 3) IGRAs could be useful as rule-out tests for active TB.<\/jats:p><jats:p>We evaluated the accuracy of two IGRAs (QuantiFERON\u00ae-TB Gold In-tube (QFT-GIT) and T-SPOT\u00ae.<jats:italic>TB<\/jats:italic>) in 395 patients (27% HIV-infected) with suspected TB in Cape Town, South Africa.<\/jats:p><jats:p>IGRA sensitivity and specificity (95% CI) were 76% (68\u201383%) and 42% (36\u201349%) for QFT-GIT and 84% (77\u201390%) and 47% (40\u201353%) for T-SPOT\u00ae.<jats:italic>TB<\/jats:italic>, respectively. Although interferon-\u03b3 responses were significantly higher in the TB<jats:italic>versus<\/jats:italic>non-TB groups (p&lt;0.0001), varying the cut-offs did not improve discriminatory ability. In culture-negative patients, depending on whether those with clinically diagnosed TB were included or excluded from the analysis, the negative predictive value (NPV) of QFT-GIT, T-SPOT\u00ae.<jats:italic>TB<\/jats:italic>and chest radiograph in smear-negative patients varied between 85 and 89, 87 and 92, and 98% (for chest radiograph), respectively. Overall accuracy was independent of HIV status and CD4 count.<\/jats:p><jats:p>In a high-burden setting, IGRAs alone do not have value as rule-in or -out tests for active TB. In smear-negative patients, chest radiography had better NPV even in HIV-infected patients.<\/jats:p>","DOI":"10.1183\/09031936.00181610","type":"journal-article","created":{"date-parts":[[2011,2,25]],"date-time":"2011-02-25T01:57:15Z","timestamp":1298599035000},"page":"649-656","source":"Crossref","is-referenced-by-count":59,"title":["Are interferon-\u03b3 release assays useful for diagnosing active tuberculosis in a high-burden setting?"],"prefix":"10.1183","volume":"38","author":[{"given":"D.I.","family":"Ling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Pai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Davids","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Brunet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Lenders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Meldau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Calligaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Allwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"van Zyl-Smit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Peter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Bateman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Dawson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Dheda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2011,2,24]]},"reference":[{"key":"2024102020351745000_38.3.649.1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.9.1009"},{"key":"2024102020351745000_38.3.649.2","unstructured":"WHO. Global Tuberculosis Control: Surveillance, Planning, Financing. Geneva, World Health Organization, 2008."},{"key":"2024102020351745000_38.3.649.3","doi-asserted-by":"publisher","DOI":"10.1086\/518656"},{"key":"2024102020351745000_38.3.649.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60284-0"},{"key":"2024102020351745000_38.3.649.5","doi-asserted-by":"publisher","DOI":"10.1053\/S0882-0546(03)00072-0"},{"key":"2024102020351745000_38.3.649.6","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00110210"},{"key":"2024102020351745000_38.3.649.7","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00040910"},{"key":"2024102020351745000_38.3.649.8","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00019709"},{"key":"2024102020351745000_38.3.649.9","doi-asserted-by":"publisher","DOI":"10.1086\/509927"},{"key":"2024102020351745000_38.3.649.10","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00055310"},{"key":"2024102020351745000_38.3.649.11","doi-asserted-by":"publisher","DOI":"10.1086\/509928"},{"key":"2024102020351745000_38.3.649.12","doi-asserted-by":"crossref","first-page":"325","DOI":"10.7326\/0003-4819-148-5-200803040-00003","article-title":"Improved diagnostic evaluation of suspected tuberculosis","volume":"148","author":"Dosanjh","year":"2008","journal-title":"Ann Intern Med"},{"key":"2024102020351745000_38.3.649.13","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2805"},{"key":"2024102020351745000_38.3.649.14","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.47.0389"},{"key":"2024102020351745000_38.3.649.15","first-page":"269","article-title":"Accuracy of an interferon-\u03b3 release assay to detect active pulmonary and extra-pulmonary tuberculosis","volume":"12","author":"Nishimura","year":"2008","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024102020351745000_38.3.649.16","doi-asserted-by":"publisher","DOI":"10.1128\/CDLI.12.4.491-496.2005"},{"key":"2024102020351745000_38.3.649.17","first-page":"1","article-title":"Updated recommendations on interferon \u03b3 release assays for latent tuberculosis infection. An Advisory Committee Statement (ACS)","volume":"34","year":"2008","journal-title":"Can Commun Dis Rep"},{"key":"2024102020351745000_38.3.649.18","first-page":"1","article-title":"Updated guidelines for using interferon \u03b3 release assays to detect Mycobacterium tuberculosis infection \u2013 United States, 2010","volume":"59","author":"Mazurek","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2024102020351745000_38.3.649.19","unstructured":"HPA Tuberculosis Programme Board. Health Protection Agency position statement on the use of Interferon Gamma Release Assay (IGRA) tests for tuberculosis (TB). London, Health Protection Agency, 2008."},{"key":"2024102020351745000_38.3.649.20","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1183\/09031936.00114810","article-title":"Interferon-\u03b3 release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis","volume":"37","author":"Sester","year":"2010","journal-title":"Eur Respir J"},{"key":"2024102020351745000_38.3.649.21","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1111\/j.1469-0691.2011.03555.x","article-title":"Guidelines on IGRAs for tuberculosis infection: concordance, discordance or confusion","volume":"18","author":"Denkinger","year":"2011","journal-title":"Clin Microbiol Infect"},{"key":"2024102020351745000_38.3.649.22","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-2350"},{"key":"2024102020351745000_38.3.649.23","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2172-10-31"},{"key":"2024102020351745000_38.3.649.24","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00026-08"},{"key":"2024102020351745000_38.3.649.25","first-page":"50","article-title":"Evaluation of cut-off values of interferon-\u03b3-based assays in the diagnosis of M. tuberculosis infection","volume":"12","author":"Soysal","year":"2008","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024102020351745000_38.3.649.26","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0b013e32832a0adc"},{"key":"2024102020351745000_38.3.649.27","first-page":"1088","article-title":"Development and evaluation of a new chest radiograph reading and recording system for epidemiological surveys of tuberculosis and lung disease","volume":"9","author":"Den Boon","year":"2005","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024102020351745000_38.3.649.28","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2236-c1"},{"key":"2024102020351745000_38.3.649.29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0002489"},{"key":"2024102020351745000_38.3.649.30","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02411-05"},{"key":"2024102020351745000_38.3.649.31","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-10-75"},{"key":"2024102020351745000_38.3.649.32","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31820b07ab"},{"key":"2024102020351745000_38.3.649.33","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00045509"},{"key":"2024102020351745000_38.3.649.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2007.02.005"},{"key":"2024102020351745000_38.3.649.35","doi-asserted-by":"publisher","DOI":"10.1086\/502977"},{"key":"2024102020351745000_38.3.649.36","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0009051"},{"key":"2024102020351745000_38.3.649.37","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70043-X"},{"key":"2024102020351745000_38.3.649.38","first-page":"52","article-title":"Chest radiograph reading and recording system: evaluation for tuberculosis screening in patients with advanced HIV","volume":"14","author":"Dawson","year":"2010","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024102020351745000_38.3.649.39","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0002624"},{"key":"2024102020351745000_38.3.649.40","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00153408"},{"key":"2024102020351745000_38.3.649.41","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.127555"},{"key":"2024102020351745000_38.3.649.42","unstructured":"Strategic and Technical Advisory Group for Tuberculosis. Report of the Tenth Meeting: Diagnostic policies. World Health Organization, Geneva, 2010"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/09031936.00181610","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:28:48Z","timestamp":1740378528000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/09031936.00181610"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,2,24]]},"references-count":42,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2011,8,31]]},"published-print":{"date-parts":[[2011,9]]}},"alternative-id":["10.1183\/09031936.00181610"],"URL":"https:\/\/doi.org\/10.1183\/09031936.00181610","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,2,24]]}}}