Tuberculosis (TB) remains one of the most serious public health problems with one third of the world population latently infected with Mycobacterium tuberculosis. The diagnosis of LTBI relied until... Show moreTuberculosis (TB) remains one of the most serious public health problems with one third of the world population latently infected with Mycobacterium tuberculosis. The diagnosis of LTBI relied until recently on the tuberculin skin test (TST) where a crude mixture of antigens is injected intradermally and induration is measured after 74 hours. False-positive test results occur frequently and are due to cross-reactivity with prior BCG-vaccination or infection with other Mycobacteria. A few years ago new in-vitro assays have been developed who use the TB-specific antigens ESAT-6 and CFP-10. They are commonly referred to as interferon-g release assays (IGRA) and have been evaluated in the studies described in this thesis. These studies have shown that IGRA have added value for the specific diagnosis of LTBI, but as is the case for any other assay, they have limitations as well. The results of IGRA should therefore be interpreted carefully in the light of the setting and the complete clinical data. Future research should not be limited to enhance the performance of IGRA but also include new opportunities, like an improved skin test of the detection of bacterial products in clinical specimens. Show less
