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Laboratory diagnosis of tuberculosis based on Interferon-Gamma Release Assay (IGRA)
BEDNÁŘOVÁ, Marcela
Interferon-gamma release assay (IGRA) methods have become a common part of the routine tuberculosis (TB) diagnosis. These are indirect diagnostic methods, which detect the cell-mediated immune reactivity to the presence of Mycobacterium tuberculosis antigens inside the human body. The methods are based on the principle of detection of interferon-gama(IFN-gama) produced by the T-lymphocytes sensitized by TB antigens. Currently, there are two tests available (QuantiFERON -TB Gold In -Tube and T - SPOT.TB). This thesis is dealing with the principle, the practical use and the place of IGRA methods in the comprehensive diagnosis of TB. The Collection of 1554 blood samples, examined by QuantiFERON-TB Gold In-Tube in the period from 1st June 2011 to 30th June 2013 in the Mycobacteriology Laboratory of the University Hospital in Pilsen was evaluated in the practical part. The percentage of various types of health care settings indicating this examination, as well as the percentage of positive, negative and undetermined results in some selected groups of patients (screening before the initiation of biological treatment, in patients with primary lung tumors, in person with a high-risk of TB and person in contact with active form of the disease) was monitored. The results of patients with active TB verified by culture were also assessed. The results of this study indicated, that IGRA methods are of a great contribution in the TB diagnosis, in particular in the latent form, under certain conditions also in the active form. At the same time it should bementioned, that the diagnosis of tuberculosis must always be complex. This method should not be used for the TB diagnosis solely.
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