INTRODUCTION: Targeted testing and treatment of individuals with @entity9178 ( @entity9178 ), at high risk of @entity378 (ATB), are key elements in the battle against @entity378 , both in France and in many parts of the world. Though the finding of tubercle bacilli is the essential examination for the diagnosis of ATB, there is no indisputable @entity1062 for @entity9178 . BACKGROUND: The help currently given to the diagnosis of @entity9178 by the degree of positivity of the @entity272 ( @entity272 ) is limited, both operationally and logistically, in populations vaccinated with BCG or sensitised by atypical mycobacteria, and by its low sensitivity in those immuno-suppressed @entity1 who are at greatest risk of progression. Moreover the @entity272 has other operational limitations linked to return visits, repeat testing causing a boosting effect and subjective interpretation. A new approach follows the availability of two biological tests for the diagnosis of @entity9178 (QuantiFERON- @entity1906 and T-SPOT- @entity1906 ) that measure the in-vitro production of @entity379 ) by the blood mononuclear cells in response to M. @entity378 specific antigens (ESAT-6 and CFP10).This revue analyses the published studies, undertaken with varying numbers of @entity1 , that evaluate the diagnostic accuracy of these two tests in comparison with @entity272 . However, validation is handicapped by the lack of a "gold standard" for the diagnosis of @entity9178 . These studies demonstrate similar levels of specificity for the two biological tests. They are statistically higher than those for @entity272 , particularly in populations vaccinated by BCG. On the other hand, their sensitivity was at least equivalent to that of @entity272 and, in certain studies, superior with T-SPOT- @entity1906 . Finally, several studies in contacts have been undertaken with the aim of measuring the concordance between these biological tests and @entity272 . The essential finding is of a very good correlation between positivity of the biological tests and the degree of exposure of the contacts. These tests have additional operational advantages over @entity272 : completed in one visit, results available in 24 hours, absence of inter and intra observer divergence, detection of potential immuno- @entity308 and avoidance of boosting by repeat testing. VIEWPOINT: Currently, however, these biological tests present several operational limits: lower sensitivity in severe disease, incomplete data in immuno-suppressed subjects and in @entity1 , lack of predictive value for future development of ATB, lack of distinction between @entity9178 and ATB. Numerous clinical studies are under way, in France and elsewhere, in order to reduce these limitations and to allow the appropriate incorporation of these tests into protocols for the diagnosis of @entity378 . CONCLUSIONS: These two biological tests should, in the near future, replace or complement @entity272 in the diagnosis of recent @entity9178 , leading to their optimal incorporation into the decision making processes of the national plans for the control of @entity378 .

[New immunological tests in the diagnosis of XXXX ].

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'persons'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression'] @entity9178 :: ('MESH:D055985', 'Disease') :: ['LTBI', 'latent tuberculosis infection'] @entity1906 :: ('MESH:D014390', 'Disease') :: ['TB'] @entity379 :: ('3458', 'Gene') :: ['interferon gamma (IFN-gamma'] @entity1062 :: ('MESH:D013736', 'Disease') :: ['test'] @entity272 :: ('MESH:D012871', 'Disease') :: ['TST', 'tuberculin skin test'] @entity378 :: ('MESH:D014376', 'Disease') :: ['progression to active tuberculosis', 'tuberculosis']
@entity378 :: (MESH:D014376,Disease) :: ['tuberculosis']
