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Topic Review: Screening for Latent Tuberculosis (LTB). Author: Peter R. McNally, DO, FACP, FACG Center for Human Simulation University of Colorado – Denver, SOM. Tables & Figures McNally.VHJOE.TR.TB.2010.N0.3. Table 1. Digestive and Hepatic Disorders Requiring Immune Suppression Therapy.
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Topic Review: Screening for Latent Tuberculosis (LTB). Author: Peter R. McNally, DO, FACP, FACG Center for Human Simulation University of Colorado – Denver, SOM Tables & Figures McNally.VHJOE.TR.TB.2010.N0.3
Table 1. Digestive and Hepatic Disorders Requiring Immune Suppression Therapy • Crohn’s Disease • Ulcerative colitis • Autoimmune Hepatitis • Recipient of Organ Transplantation
Table 2. High Risk Groups Cutoffs for (+) Mantoux TST
Table 3. Moderate Risk Groups Cutoffs for (+) Mantoux TST
Table 4. Differences Between Currently Available INF-γ Release Assays
Table 5. Comparison of LTB DetectionWith TST and INF-γ Release Assay
Table 6. CDC Guidance on Selection of TST or IGRA • Situations IGRA is preferred, but a TST is acceptable • Testing persons with poor TST 48 hr return rates • Previously BCG vaccine or cancer therapy • Situations TST is preferred, but IGRA is acceptable • Children < 5 yrs (some experts require both TST & IGRA) • Situations where No Preference TST = IGRA • Recent contacts of MTB • MTB Screening & Surveillance Programs • Situations Both IGRA and TST may be considered • When either test (-) and risk for MTB high and outcome poor • IGRA indeterminate, TST may be helpful
Figure 1. Estimated TB incidence rates, 2008 http://whqlibdoc.who.int/publications/2009/9789241598866_eng.pdf
Figure 2. Mantoux TST A. Intra-dermal PPD Injection B. Size of induration, not erythrema should be measured. http://en.wikipedia.org/wiki/File:Mantoux_test.jpg