Challenges in interpreting IGRA results in various clinical settings
| Subgroups considered for IGRA testing by NICE | Uncertainties of IGRAs | ||
|---|---|---|---|
| New entrants from high incidence countries | } | Which immigrant subgroups to target? | |
| Contacts of a TB outbreak | What is the meaning of reversion? | ||
| Healthcare workers | |||
| Adult contacts of active TB cases | |||
| Paediatric contacts of active TB cases* | } | False negative rates unknown in high-risk populations | |
| Immunocompromised patients* | |||
| Active TB† | False negative rates in 15–25% | ||
| Active and latent TB: effect of treatment† | { | Increased risk of false negative results | |
| Unsuitable for treatment monitoring | |||
*NICE recommends testing with both IGRA and the tuberculin skin test.
†NICE does not recommend IGRA testing but highlights potential uses which are the subject of further study.
IGRA, interferon gamma release assay; NICE, National Institute for Health and Clinical Excellence; TB, tuberculosis.