Table 1

Challenges in interpreting IGRA results in various clinical settings

Subgroups considered for IGRA testing by NICEUncertainties of IGRAs
New entrants from high incidence countries}Which immigrant subgroups to target?
Contacts of a TB outbreakWhat 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.