ArticleThe clinical respiratory journal2023
Tuberculin skin test and interferon-γ release assays: Can they agree?
Article in The clinical respiratory journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- Advancement in diagnostic approaches for latent tuberculosis: distinguishing recent from remote infections.One health outlook · 2025Review
- Novel LAM Assay Shown Satisfactory Results in the Detection of Tuberculosis.Infection and drug resistance · 2025Article
- Impact of diabetes mellitus on tuberculosis prevention, diagnosis, and treatment from an immunologic perspective.Exploration (Beijing, China) · 2024Review
- Tuberculin skin test and interferon-γ release assays: Can they agree?The clinical respiratory journal · 2023Article
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
introductionThe diagnosis of latent tuberculosis infection (LTBI) relies largely on the tuberculin skin test (TST) or, more recently, on interferon-gamma release assays (IGRA). Knowledge regarding these tests is essential to improve their usefulness in combating the tuberculosis epidemic.
objectivesTo characterize the agreement between the IGRA and TST tests by determining the kappa coefficient (K) and agreement rate between these two tests in patients with active tuberculosis (TB).
methodsRetrospective cohort study conducted with data from active TB patients notified in the Portuguese Tuberculosis Surveillance System (SVIG-TB), from 2008 to 2015. TST results were interpreted using a 5 mm (TST-5 mm) and 10 mm (TST-10 mm) cutoff. Kappa coefficient and agreement rate were calculated in order to evaluate the agreement between IGRA and TST (both cutoffs) test results.
resultsA total of 727 patients with results for both tests were included in the study, of which 3.4% (n = 25) had HIV infection, 5.6% (n = 41) diabetes, 5.0% (n = 36) oncological diseases and 4.4% (n = 32) inflammatory diseases. Of the 727 patients, 16.5% (n = 120) presented different outcomes between IGRA and TST-5 mm, and 20.5% (n = 149) presented different outcomes between IGRA and TST-10 mm. Kappa coefficient between IGRA and TST-5 mm was 0.402 (p < 0.001) with an agreement rate of 83.5%. Between IGRA and TST-10 mm, the kappa coefficient was 0.351 (p < 0.001), with an agreement rate of 79.5%. Patients with HIV infection, diabetes, oncologic diseases and inflammatory diseases presented a substantial agreement between IGRA and TST-5 mm, while inflammatory diseases was the only variable that presented a substantial agreement between IGRA and TST-10 mm.
conclusionAs both tests can present false-negative results, the low level of agreement between the tests can potentially help identify more cases of LTBI if the two tests are used in parallel, with infections not detected by IGRA possibly being detected by the TST and vice versa.
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