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Evaluating latent tuberculosis infection diagnostics using latent class analysis.

Publication ,  Journal Article
Stout, JE; Wu, Y; Ho, CS; Pettit, AC; Feng, P-J; Katz, DJ; Ghosh, S; Venkatappa, T; Luo, R; Tuberculosis Epidemiologic Studies Consortium,
Published in: Thorax
November 2018

BACKGROUND: Lack of a gold standard for latent TB infection has precluded direct measurement of test characteristics of the tuberculin skin test and interferon-γ release assays (QuantiFERON Gold In-Tube and T-SPOT.TB). OBJECTIVE: We estimated test sensitivity/specificity and latent TB infection prevalence in a prospective, US-based cohort of 10 740 participants at high risk for latent infection. METHODS: Bayesian latent class analysis was used to estimate test sensitivity/specificity and latent TB infection prevalence among subgroups based on age, foreign birth outside the USA and HIV infection. RESULTS: Latent TB infection prevalence varied from 4.0% among foreign-born, HIV-seronegative persons aged <5 years to 34.0% among foreign-born, HIV-seronegative persons aged ≥5 years. Test sensitivity ranged from 45.8% for the T-SPOT.TB among foreign-born, HIV-seropositive persons aged ≥5 years to 80.7% for the tuberculin skin test among foreign-born, HIV-seronegative persons aged ≥5 years. The skin test was less specific than either interferon-γ release assay, particularly among foreign-born populations (eg, the skin test had 70.0% specificity among foreign-born, HIV-seronegative persons aged ≥5 years vs 98.5% and 99.3% specificity for the QuantiFERON and T-SPOT.TB, respectively). The tuberculin skin test's positive predictive value ranged from 10.0% among foreign-born children aged <5 years to 69.2% among foreign-born, HIV-seropositive persons aged ≥5 years; the positive predictive values of the QuantiFERON (41.4%) and T-SPOT.TB (77.5%) were also low among US-born, HIV-seropositive persons aged ≥5 years. CONCLUSIONS: These data reinforce guidelines preferring interferon-γ release assays for foreign-born populations and recommending against screening populations at low risk for latent TB infection. TRIAL REGISTRATION NUMBER: NCT01622140.

Duke Scholars

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Published In

Thorax

DOI

EISSN

1468-3296

Publication Date

November 2018

Volume

73

Issue

11

Start / End Page

1062 / 1070

Location

England

Related Subject Headings

  • Young Adult
  • United States
  • Tuberculin Test
  • Respiratory System
  • Reproducibility of Results
  • Prospective Studies
  • Mycobacterium tuberculosis
  • Middle Aged
  • Mass Screening
  • Male
 

Citation

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Chicago
ICMJE
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Stout, J. E., Wu, Y., Ho, C. S., Pettit, A. C., Feng, P.-J., Katz, D. J., … Tuberculosis Epidemiologic Studies Consortium, . (2018). Evaluating latent tuberculosis infection diagnostics using latent class analysis. Thorax, 73(11), 1062–1070. https://doi.org/10.1136/thoraxjnl-2018-211715
Stout, Jason E., Yanjue Wu, Christine S. Ho, April C. Pettit, Pei-Jean Feng, Dolly J. Katz, Smita Ghosh, Thara Venkatappa, Ruiyan Luo, and Ruiyan Tuberculosis Epidemiologic Studies Consortium. “Evaluating latent tuberculosis infection diagnostics using latent class analysis.Thorax 73, no. 11 (November 2018): 1062–70. https://doi.org/10.1136/thoraxjnl-2018-211715.
Stout JE, Wu Y, Ho CS, Pettit AC, Feng P-J, Katz DJ, et al. Evaluating latent tuberculosis infection diagnostics using latent class analysis. Thorax. 2018 Nov;73(11):1062–70.
Stout, Jason E., et al. “Evaluating latent tuberculosis infection diagnostics using latent class analysis.Thorax, vol. 73, no. 11, Nov. 2018, pp. 1062–70. Pubmed, doi:10.1136/thoraxjnl-2018-211715.
Stout JE, Wu Y, Ho CS, Pettit AC, Feng P-J, Katz DJ, Ghosh S, Venkatappa T, Luo R, Tuberculosis Epidemiologic Studies Consortium. Evaluating latent tuberculosis infection diagnostics using latent class analysis. Thorax. 2018 Nov;73(11):1062–1070.

Published In

Thorax

DOI

EISSN

1468-3296

Publication Date

November 2018

Volume

73

Issue

11

Start / End Page

1062 / 1070

Location

England

Related Subject Headings

  • Young Adult
  • United States
  • Tuberculin Test
  • Respiratory System
  • Reproducibility of Results
  • Prospective Studies
  • Mycobacterium tuberculosis
  • Middle Aged
  • Mass Screening
  • Male