Guidelines for the use of interferon-? release assays in the diagnosis of tuberculosis infection
Por:
Santin M., García-García J.-M., Domínguez J., Rigau D., Altet N., Anibarro L., Casas I., Díez N., García-Gasalla M., Martínez-Lacasa X., Penas A., Pérez-Escolano E., Sánchez F.
Publicada:
1 ene 2016
Resumen:
Introduction: Interferon-gamma release assays are widely used for the diagnosis of tuberculosis infection in low-prevalence countries. However, there is no consensus on their application. The objective of this study was to develop guidelines for the use of interferon-gamma release assays in specific clinical scenarios in Spain. Methods: A panel of experts comprising specialists in infectious diseases, respiratory diseases, microbiology, pediatrics and preventive medicine, together with a methodologist, formulated the clinical questions and outcomes of interest. They conducted a systematic literature search, summarized the evidence and rated its quality, and prepared the recommendations following the GRADE (Grading of Recommendations of Assessment Development and Evaluations) methodology. Results: The panel prepared recommendations on the use of interferon-gamma release assays for the diagnosis of tuberculosis infection in the contact-tracing study (both adults and children), health care workers, immunosuppressed patients (patients infected with human immunodeficiency virus, patients with chronic immunomediated inflammatory diseases due to start biological therapy and patients requiring organ transplant) and for the diagnosis of active tuberculosis. Most recommendations were weak, mainly due to the lack of good quality evidence to balance the clinical benefits and disadvantages of the interferon-gamma release assays as compared with the tuberculin skin test. Conclusion: This document provides evidence-based guidance on the use of interferon-gamma release assays for the diagnosis of tuberculosis infection in patients at risk of tuberculosis or with suspicion of active disease. The guidelines will be applicable in specialist and primary care and in public health settings. © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.
Filiaciones:
Santin M.:
Service of Infectious Diseases, Bellvitge University Hospital, IDIBELL, C/Feixa Llarga, s/n, l'Hospitalet de Llobregat, Barcelona 08907, Spain
Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
García-García J.-M.:
Clinical Unit of Pneumology, Hospital San Agustín, C/Camino de Heros, 4, Avilés, Asturias 33400, Spain
Domínguez J.:
Service of Microbiology, Research Institute Trias i Pujol, Hospital Gremans Trias i Pujol, Carretera del Canyet, s/n, Badalona, Barcelona 08916, Spain
Department of Genetics and Microbiology, Universidad Autónoma de Barcelona, Barcelona, Spain
CIBER Respiratory Diseases, Madrid, Spain
Rigau D.:
Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/Sant Antoni Maria Claret, 167, Barcelona, 08025, Spain
Altet N.:
Unit of Tuberculosis Valle de Hebron, Institute of Research in Primary Assistance Jordi Gol, Unidad Clínicade Tratamiento Directamente Observado Servicios Clínicos, C/Garcia Mariño, 4, Barcelona, 08022, Spain
Anibarro L.:
Unit of Tuberculosis, Infectious Diseases, Service of Internal Medicine, Complexo Hospitalario de Pontevedra, Pontevedra, 36001, Spain
Casas I.:
Service of Preventive Medicine, Hospital Gremans Trias i Pujol, Carretera del Canyet, s/n, Badalona, Barcelona 08916, Spain
Department of Pediatrics, Obstetrics-Gynecology and Preventive Medicine, Universidad Autónoma de Barcelona, Barcelona, Spain
Díez N.:
Service of Pediatrics, Hospital Universitario Rio Hortega, Calle Dulzaina, 2, Valladolid, 47012, Spain
García-Gasalla M.:
Service of Internal Medicine/Infectious Diseases, Hospital Son Llàtzer, Carretera de Manacor, 4, Palma de Mallorca, 07198, Spain
Martínez-Lacasa X.:
Unit of Tuberculosis Control, Hospital Universitario Mutua de Terrassa, Pza. Dr Robert, 5, Terrassa, Barcelona 08224, Spain
Penas A.:
Unit of Tuberculosis, Service of Pneumology, Hospital Universitario Lucus Augusti, C/San Cibrao, Lugo, 27003, Spain
Pérez-Escolano E.:
Service of Internal Medicine, Infectious Diseases, Hospital de Jerez, Ctra. Circunvalación, s/n, Jerez de la Frontera, Cádiz 11407, Spain
Sánchez F.:
Service of Infectious Diseases, Instituto Mar de Investigaciones Médicas (IMIM), Hospital del Mar, Dr. Aiguader, 88, Barcelona, 08003, Spain
|