Table 1.
Worldwide guidelines on recommendations of interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST) for tuberculosis infection in the immunocompromised population.
| WHO (International) 1 | NTAC/CDC (The United State) 2 | NICE (Britain) 3 | SEIMC/SEPAR (Spain) 4 | |
|---|---|---|---|---|
| Latent tuberculosis infection (LTBI) | ||||
| Pregnant and puerperal women | Not mentioned | Not mentioned | Not mentioned | Not mentioned |
| Older people | Not mentioned | Not mentioned | Not mentioned | Not mentioned |
| Children | ||||
| >5 years old | Either (contacts of patients with ATBI) | Either, but IGRAs preferred | IGRAs when the initial TST is negative (contacts of patients with ATBI) | TST (contacts of patients with ATBI) |
| <5 years old | Either (contacts of patients with ATBI) | Either, but TST preferred | IGRAs when the initial TST is negative (contacts of patients with ATBI) | Both (contacts of patients with ATBI) |
| Human immunodeficiency virus infection | ||||
| CD4 + T-cell < 200 cells/μL | Either | Either | IGRAs or IGRAs + TST | Both |
| CD4 + T-cell < 200 cells/μL | Either | Both | IGRAs + TST | IGRAs |
| Solid organ transplant recipients | Either | Either (low-risk) Both (high-risk) |
IGRAs + TST | Both |
| Chronic immuno-mediated inflammatory diseases | Either (patients receiving tumor necrosis factor-α blockers) | Either (low-risk) Both (high-risk) |
IGRAs or IGRAs + TST (patients receiving tumor necrosis factor-α blockers) | Both |
| End-stage renal disease | Either (patients receiving dialysis) | Either (low-risk) Both (high-risk) |
IGRAs or IGRAs + TST | Not mentioned |
| End-stage liver disease | Not mentioned | Either (low-risk) Both (high-risk) |
Not mentioned | Not mentioned |
| Diabetes mellitus | No screening is required | Not mentioned | IGRAs or IGRAs + TST | Not mentioned |
| Active tuberculosis infection (ATBI) | Neither | Both as adjunctive tests for children | Both as complementary tests for children <15 years old | Both as complementary tests for children >5-year-old |
1 World Health Organization. Its recommendations are limited to the high/middle-income countries. In the low/middle-income countries, IGRAs should not replace the TST. 2 National Tuberculosis Advisory Committee/Centers for Disease Control and Prevention. 3 National Institute for Health and Care Excellence. 4 Spanish Society of Infectious Diseases and Clinical Microbiology/Spanish Society of Respiratory Diseases and Thoracic Surgery.