Many diagnosed with an underlying condition don’t realize that they are immunocompromised.1 Those with compromised immune systems face a higher risk of contracting tuberculosis (TB) and a higher risk of latent tuberculosis infection (LTBI) becoming active. The Centers for Disease Control and Prevention (CDC) has published the following list of people at high-risk for developing active TB disease once infected with Mycobacterium tuberculosis (MTB):2,3
Persons living with diabetes
34,200,000 people live with diabetes4
Persons living with Crohn’s disease or other inflammatory bowel disease
3,000,000 people live with Crohn’s disease or other inflammatory bowel disease5
Persons living with rheumatoid arthritis
1,500,000 people live with rheumatoid arthritis6
Persons living with HIV/AIDS
1,100,000 people live with HIV/AIDS7
Persons living with chronic kidney disease
37,000,000 people live with chronic kidney disease8
Persons who are receiving immunosuppressive therapy
Persons who were recently infected with MTB (within the past 2 years)
Persons with a history of untreated or inadequately treated active TB disease
Persons living with leukemia, lymphoma or cancer of the head, neck or lung
Persons who have had a gastrectomy or jejunoileal bypass
Persons who weigh less than 90% of their ideal body weight
Persons who smoke cigarettes or abuse drugs or alcohol
Populations defined locally as having an increased incidence of active TB disease, possibly including medically underserved or low-income populations
Why are the immunocompromised at risk?
There are many reasons for the increased risk faced by those with compromised immune systems. These include:
Risk of progression from LTBI to active TB can be much higher than in a healthy population9
TB infection can increase the progression of comorbid conditions, such as HIV10
Management of TB can be complicated by drug interactions and cumulative toxicities11
Reduced T cell counts and functionality can make it difficult for some tests to detect an immune response to MTB infection12
The T-SPOT.TB test is the only IGRA without a warning or limitation in their package insert for screening immunocompromised individuals13,14
The reliability of the T-SPOT.TB test design, which includes washing and standardizing the number of cells in each patient specimen, is supported by clinical data obtained even in challenging patient populations. The cell enumeration technology in the proprietary T-SPOT.TB test therefore will allow clinicians to confidently screen and detect TB infection.13
Patient populations can vary, but your TB test results should not. The T-SPOT.TB test is accurate across patient populations. In fact, the T-SPOT.TB test is the only TB test without a warning against use in the immunocompromised in the package insert.
Accurate across patient populations13
Only TB test with sensitivity and specificity > 95%13
FDA-approved borderline zone provides increased test resolution for results around the cut-off point15,16
Lai CC, Tan CK,et al. Diagnostic performance of whole-blood interferon-γ assay and enzyme-linked immunospot assay for active tuberculosis. J Microbiol Immunol Infect. 2011 Oct;44(5):406-7. doi: 10.1016/j.jmii.2011.07.002. Epub 2011 Sep 8.
Qiagen. QuantiFERON-TB Gold Plus (QFT-Plus) ELISA Package Insert. 1095849 Rev. 06. November 2019.
Rego K, Pereira K, MacDougall J, Cruikshank W. Utility of the T-SPOT®.TB test’s borderline category to increase test resolution for results around the cut-off point. Tuberculosis. 2018;108:178-185. doi:10.1016/j.tube.2017.12.005.
Mazurek GH, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K, IGRA Expert Committee, Centers for Disease Control and Prevention (CDC). Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis infection – United States, 2010. MMWR Recomm Rep. 2010;59(RR-5):1-25.
QFT is a registered trademark of The Qiagen Group.
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