{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T11:40:03Z","timestamp":1750678803459,"version":"3.41.0"},"reference-count":38,"publisher":"European Respiratory Society (ERS)","issue":"3","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2024,11,25]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The 2016 National Institute for Health and Care Excellence guidelines recommended the tuberculin skin test (TST), at a 5-mm induration size cut-off, for the diagnosis of latent tuberculosis infection (LTBI) among adult close contacts of active tuberculosis (TB) cases. This study analysed a well-characterised cohort of adult close contacts in London and assessed the cost-effectiveness of LTBI screening strategies with combinations of TST and interferon-\u03b3 release assays (IGRAs) in a decision-analytic model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Close contacts of pulmonary TB cases who were tested with TST and IGRA between January 2008 and December 2010 were retrospectively reviewed. Using an NHS perspective and lifetime horizon, a decision-analytic Markov model was used to compare costs and quality-adjusted life-years (QALYs) associated with five screening strategies followed by LTBI treatment: 1) TST alone; 2) QuantiFERON-TB Gold In-Tube (QFT) alone; 3) T-SPOT.TB (T-SPOT) alone; 4) TST positive followed by QFT; 5) TST positive followed by T-SPOT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 381 asymptomatic close contacts aged 18 to 65\u2005years (mean\u00b1<jats:sc>sd<\/jats:sc>35.2\u00b111.3). 75.3% had received BCG vaccination. Among the five strategies, for a willingness-to-pay threshold of GBP 25\u2009000 and using incremental net monetary benefit (INMB) with TST as comparator, the IGRA-alone strategies were the most cost-effective, marginally QFT over T-SPOT (QFT: GBP 214; T-SPOT: GBP 199).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Single-step IGRA, particularly QuantiFERON, is preferable for LTBI screening of adult close contacts of pulmonary TB cases.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00818-2024","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T17:00:20Z","timestamp":1739466020000},"page":"00818-2024","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Latent tuberculosis infection screening of adult close contacts: a cost\u2013utility analysis"],"prefix":"10.1183","volume":"11","author":[{"given":"Nathan","family":"Green","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kavina","family":"Manalan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Hayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"O'Donoghue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6548-5673","authenticated-orcid":false,"given":"Suranjith","family":"Seneviratne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Drey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2647-4688","authenticated-orcid":false,"given":"Onn Min","family":"Kon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"2025062304001165000_11.3.00818-2024.1","unstructured":"World Health Organization . 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