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T cell hyporesponsiveness due to immunosuppression caused by illness or drugs, referred to as anergy, may produce false-negative tuberculin skin test (TST) and interferon-\u03b3 release assay (IGRA) results. The literature suggests that anergy may influence screening performance of TST and IGRA tests in candidates for anti-TNF-\u03b1 therapy. Conversely, the potential for false-positive TST and IGRA results must be considered, as treatment for LTBI may be associated with significant morbidity. This review examines the reliability issues related to LTBI diagnostic testing and provides practical direction to help prevent LTBI reactivation and facilitate successful anti-TNF-\u03b1 treatment.<\/jats:p>","DOI":"10.3899\/jrheum.100623","type":"journal-article","created":{"date-parts":[[2011,4,1]],"date-time":"2011-04-01T23:52:41Z","timestamp":1301701961000},"page":"1234-1243","source":"Crossref","is-referenced-by-count":41,"title":["Challenges in Diagnosing Latent Tuberculosis Infection in Patients Treated with Tumor Necrosis Factor Antagonists"],"prefix":"10.3899","volume":"38","author":[{"given":"EDWARD C.","family":"KEYSTONE","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KIM A.","family":"PAPP","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"WENDY","family":"WOBESER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2011,4,1]]},"reference":[{"key":"2018112909263815000_38.7.1234.1","doi-asserted-by":"publisher","DOI":"10.1086\/506935"},{"key":"2018112909263815000_38.7.1234.2","doi-asserted-by":"publisher","DOI":"10.1086\/424455"},{"key":"2018112909263815000_38.7.1234.3","doi-asserted-by":"publisher","DOI":"10.1002\/art.24632"},{"key":"2018112909263815000_38.7.1234.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70227-5"},{"key":"2018112909263815000_38.7.1234.5","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.301.2.418"},{"key":"2018112909263815000_38.7.1234.6","doi-asserted-by":"publisher","DOI":"10.1086\/517519"},{"key":"2018112909263815000_38.7.1234.7","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20225"},{"key":"2018112909263815000_38.7.1234.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011110"},{"key":"2018112909263815000_38.7.1234.9","doi-asserted-by":"publisher","DOI":"10.1002\/art.21705"},{"key":"2018112909263815000_38.7.1234.10","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199705150-00015"},{"key":"2018112909263815000_38.7.1234.11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530020061033"},{"key":"2018112909263815000_38.7.1234.12","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1097\/00002030-199310000-00007","article-title":"A prospective study of the risk of tuberculosis among HIV-infected patients","volume":"7","author":"Guelar","year":"1993","journal-title":"AIDS"},{"key":"2018112909263815000_38.7.1234.13","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/00007890-199408000-00008","article-title":"Tuberculosis in liver transplant patients","volume":"58","author":"Meyers","year":"1994","journal-title":"Transplantation"},{"key":"2018112909263815000_38.7.1234.14","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199601270-00008"},{"key":"2018112909263815000_38.7.1234.15","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1164\/ajrccm.152.1.7599848","article-title":"Mycobacterium tuberculosis in lung transplant recipients","volume":"152","author":"Miller","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"key":"2018112909263815000_38.7.1234.16","first-page":"1127","article-title":"Tuberculosis in patients receiving anti-TNF agents despite chemoprophylaxis","volume":"10","author":"Sichletidis","year":"2006","journal-title":"Int J Tuberc Lung Dis"},{"key":"2018112909263815000_38.7.1234.17","doi-asserted-by":"publisher","DOI":"10.1002\/art.21043"},{"key":"2018112909263815000_38.7.1234.18","doi-asserted-by":"publisher","DOI":"10.1002\/art.22768"},{"key":"2018112909263815000_38.7.1234.19","unstructured":"Public Health Agency of Canada . 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