New Guidelines Recommend Wider Use of Modern Blood-Based Tuberculosis Test

QIAGEN today welcomed new evidence-based guidelines for TB screening that have broadened the preferential recommendation for the use of modern blood-based TB tests (tests based on interferon gamma release, or IGRAs) over the 100-year-old tuberculin skin test (TST) in a wider group of people at risk for latent or active tuberculosis infection.

QIAGEN’s QuantiFERON-TB^® Gold (QFT^®) is the leading IGRA in the U.S. and worldwide, with more than five million tests sold in the U.S. during the last year and seven-fold the volume of other IGRAs. This expanded preferential recommendation is expected to drive more rapid conversion from the use of the TST given that these guidelines are the first of their kind to recommend IGRAs over the TST based on disease progression risk, and not just based on patient types.

The new guidelines were the outcome of a task force supported by the American Thoracic Society (ATS), the U.S. Centers for Disease Control and Prevention (CDC), and the Infectious Diseases Society of America, and were published in the latest issue of Clinical Infectious Diseases. The updated guidelines on TB, a potentially lethal but preventable disease, were also endorsed by the European Respiratory Society.

In testing for latent tuberculosis infection (LTBI), a condition that produces no symptoms but can progress to the active form of TB, the task force strongly recommended performing an IGRA instead of the TST in people age 5 and older who are likely to be infected with the Mycobacterium tuberculosis bacteria that causes the disease as well as those with a low to intermediate risk of progression to active TB.

The guidelines also supported the use of an IGRA in people for whom it has been decided that latent TB testing is warranted, and also those who have either have been vaccinated with the BCG vaccine against TB or are unlikely to return for the required second visit for a TST test. Furthermore, the task force agreed with current U.S. guidelines that people at low risk for TB infection should not be tested, but any test performed in this group should be with an IGRA instead of a TST. The guidelines also recommended that children age 5 and younger continue to be tested with a TST, but can also be tested with an IGRA.

“Despite the global efforts, TB remains devastating and lethal disease that kills a person somewhere in the world every 18 seconds,” said Dr. Masae Kawamura, M.D., Senior Director, Medical and Scientific Affairs, TB Diagnostics, at QIAGEN. “The burden of LTBI is a major concern as the reservoir of future cases in the United States, and this was underscored by the involvement of the CDC and professional organizations in these recommendations. These new guidelines are essential in the fight against TB, especially since this is a preventable disease, and they will broaden the use of latent TB tests beyond the current focus on public health programs, specialty physicians and facilities under health regulations. QIAGEN is committed to supporting the fight on TB in the United States, as well as around the world, by advancing TB screening with the use of QuantiFERON as the leading blood test for TB testing.”

The publication of these guidelines follows the announcement in September 2016 of recommendations by the U.S. Preventive Services Task Force (USPSTF) that primary care physicians screen adult patients in groups at high risk for latent TB infections. The final USPSTF recommendations referred to QuantiFERON-TB Gold as reliable in screening and suggested IGRAs may be preferable in certain patient groups than the TST.

The USPSTF, an independent volunteer panel of experts in prevention and evidence-based medicine, issued its final recommendations on screening in primary care settings on September 6, replacing the prior guidance issued by the task force in 1996. The recommendations were published in the Journal of the American Medical Association. In this new set of recommendations, USPSTF now directed its recommendations to primary care clinicians, rather than to public agencies or specialists in diseases such as HIV, where latent TB screening already is a standard of care.