Letters Screening tests for TB before biological therapy

Limitations of current tuberculosis screening tests in immunosuppressed patients

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2226 (Published 28 April 2015) Cite this as: BMJ 2015;350:h2226
  1. Vanessa Clifford, research fellow1,
  2. Marc Tebruegge, NIHR clinical lecturer in paediatric infectious diseases and immunology2,
  3. Nigel Curtis, professor of paediatric infectious diseases3
  1. 1Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Parkville, Australia
  2. 2Academic Unit of Clinical and Experimental Medicine, Faculty of Medicine and Respiratory Biomedical Research Unit and Institute for Life Sciences, University of Southampton, Southampton, UK
  3. 3Department of Paediatrics, University of Melbourne, Parkville
  1. nigel.curtis{at}rch.org.au

We agree that a combination of an interferon γ release assay (IGRA; QuantiFERON-TB Gold in-Tube (QFT-IT) or TSPOT.TB) and a tuberculin skin test is the most sensitive approach to screening for latent tuberculosis infection in patients with rheumatological diseases before starting biological drugs.1

The authors note that skin tests can be false-negative in patients receiving corticosteroids. However, IGRAs, which are designed primarily to achieve high …

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