Abstract：Objective To evaluate the diagnostic value of IGRAs for active tuberculosis as a reference standard for tuberculin skin test (TST). Methods The PubMed, Medline, Web of Science, the Cochrane Library, EBSCO, Elsevier, Chinese Knowledge Network Database, Wanfang Data, the Chinese Biomedical Literature Database were searched, from the building up to May 2017. The quality of selected documents was evaluated by the QUADAS item scale. Stata 12.0 software was used for Meta analysis to test heterogeneity and to evaluate the publication bias of the selected literature. Results At the beginning of the examination, 871 related articles were collected. According to the inclusion and exclusion criteria of the literature, 10 urticles were selected (6 articles adopted the T - SPOT. TB method, and 7 articles adopted QFT - GIT method), including 746 patients with active tuberculosis, 806 patients with inactive tuberculosis. TST as reference standard, T - SPOT. TB test and QFT - GIT test summary of the value of active TB diagnosis sensitivity, summarizing specificity, summary positive likelihood ratio, and summarize the negative likelihood ratio, and summarize diagnostic odds ratio, aggregate area under the receiver-operating characteristic curve were respectively 81%, 67%, 2.42, 0.29, 8.57, 0.82 and 87%, 68%, 2.71, 0.20, 13.72, 0.20. Conclusion Present evidence indicates that IGRAs test is significantly better than TST for the diagnostic efficacy of active tuberculosis in adults and the differential ability of non-active TB, but the overall diagnostic strength is moderate, and the negative results of the IGRAs test can largely exclude the possibility of active tuberculosis.
[1] Macgregor V. Tuberculous Meningitis in HIV-Infected Individuals [J]. Curr HIV/AIDS Rep，2009，6：139-145.
[2] World Health Organization. Global tuberculosis control [S]. WHO Report 2013，Geneva：WHO，2013.
[3] Corbett EL，Watt CJ，Walker N，et al. The growing burden of tuberculosis：global trends and interactions with the HIV epidemic [J]. Arch Intern Med，2003，12（9）：1009-1021.
[4] Markowitz N，Hansen N，Hopewell PC，et al. Incidence of tuberculosis in the United States among HIV-infected persons. The pulmonary complications of HIV Infection Study Group [J]. Ann Intern Med，1997，15（2）：123-132.
[5] Soysal A，Bakir M. T-SPOT.TB assay usage in adults and children [J]. Expert Rev Mol Diagn，2011，11（6）：643-660.
[6] Lee E，Holzman RS. Evolution and current use of the tuberculin test [J]. Clin Infect Dis，2002，34（3）：365-370.
[7] Huebner RE，Schein MF，Bass JB. The tuberculin skin test [J]. Clin Infect Dis，1993，17（6）：968-975.
[8] Ewer K，Deeks J，Alvarez L，et al. Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium tuberculosis infection in a school tuberculosis outbreak [J]. Lancet，2003，361（9354）：1168-1173.
[9] Pai M，Dheda K，Cunningham J，et al. T-cell assays for the diagnosis of latent tuberculosis infection：moving the research agenda forward [J]. Lancet Infect Dis，2007，7（6）：428-438.
[10] Mazurek GH，Jereb J，Lobue P，et al. Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection，United States [J]. MMWR Recomm Rep，2005，54：49-55.
[11] Yu Y，Zhao X，Wang W，et al. Diagnostic performance of interferon-gamma releasing assay in HIV-infected patients in China [J]. PLoS One，2013，8（8）：e70 957.
[12] Leidl L，Mayanja-Kizza H，Sotgiu G，et al. Relationship of immunodiagnostic assays for tuberculosis and numbers of circulating CD4+ T-cells in HIV infection [J]. Eur Respir J，2010，35（3）：619-626.
[13] Jiang W，Shao L，Zhang Y，et al. High-sensitive and rapid detection of Mycobacterium tuberculosis infection by IFN-gamma release assay among HIV-infected individuals in BCG-vaccinated area [J]. BMC Immunol，2009，10： 31.
[14] Goletti D，Raja A，Ahamed Kabeer BS，et al. IFN-gamma，but not IP-10，MCP-2 or IL-2 response to RD1 selected peptides associates to active tuberculosis [J]. J Infect，2010，61：133-143.
[15] Chen X，Yang Q，Zhang M，et al. Diagnosis of active tuberculosis in China using an in-house gamma interferon enzyme-linked immunospot assay [J]. Clin Vaccine Immunol，2009，16（6）：879-884.
[16] Abdel-Samea SA，Ismail YM，Fayed SMA，et al. Comparative study between using QuantiFERON and tuberculin skin test in diagnosis of Mycobacterium tuberculosis infection [J]. Egyptian Journal of Chest Diseases and Tuberculosis，2013，62（1）：137-143.
[17] Kang YA，Lee HW，Hwang SS，et al. Usefulness of whole-blood interferon-gamma assay and interferon-gamma enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis [J]. Chest，2007，132（2）：959-965.
[18] Kim SH，Cho OH，Park SJ，et al. Diagnosis of abdominal tuberculosis by T-cell-based assays on peripheral blood and peritoneal fluid mononuclear cells [J]. J Infect，2011， 62（6）：462-471.
[19] Lee JE，Kim HJ，Lee SW. The clinical utility of tuberculin skin test and interferon-gamma release assay in the diagnosis of active tuberculosis among young adults：a prospective observational study [J]. BMC Infect Dis，2011， 11（1）：96.
[20] Mazurek GH，Weis SE，Moonan PK，et al. Prospective comparison of the tuberculin skin test and 2 whole-blood interferon-gamma release assays in persons with suspected tuberculosis [J]. Clin Infect Dis，2007，45（7）：837-845.
[21] Whiting P，Rutjes AW，Reitsma JB，et al. The development of QUADAS：a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews [J]. BMC Med Res Methodol，2003，3（3）：25.
[22] Black GF，Weir RE，Floyd S，et al. BCG-induced increase in interferon-gamma response to mycobacterial antigens and efficacy of BCG vaccination in Malawi and the UK：two randomised controlled studies [J]. Lancet，2002， 359（9315）：1393-1401.
[23] Pai M，Riley LW，Colford JM. Interferon-γ assays in the immunodiagnosis of tuberculosis：a systematic review [J]. Lancet Infect Dis，2004，4（12）：761-776.
[24] Legesse M，Ameni G，Mamo G，et al. Performance of QuantiFERON-TB Gold In-Tube（QFTGIT）for the diagnosis of Mycobacterium tuberculosis（Mtb）infection in Afar Pastoralists，Ethiopia [J]. BMC Infect Dis，2010， 10（1）：354.
2018, Vol. 15 
京公网安备 11010502046598号