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Rate of active TB and incidence rate ratio for latent TB tests in various risk groups

Rate of active TB and incidence rate ratio for latent TB tests in various risk groups
Population/clinical condition Test
(criteria for positive TST)		 Rate of TB
(per 1000 person-years)		 Incidence rate ratio
(Incidence Test Positive)
(Incidence Test Negative)
Estimate 95% CI Estimate 95% CI
General population (no TB risk factors) TST (10 mm) 0.3 0.1 to 1.1 – –
Contacts
All contacts IGRA 13.3 10.8 to 16.4 8.4 5.2 to 13.5
TST (5 mm) 8.4 4.3 to 16.5 12.5 6.4 to 22.5
TST (10 mm) 9.4 4.0 to 21.8 6.9 3.3 to 14.4
Close contacts IGRA 22.4 12.1 to 41.8 13.1 3.3 to 51.9
TST (5 mm) 10.5 7.7 to 14.3 3.7 2.1 to 6.5
TST (10 mm) 10.3 6.1 to 17.4 2.5 1.3 to 4.8
Immunocompromised patients
HIV infection IGRA 16.9 10.5 to 27.3 11.0 4.6 to 26.2
TST (5 mm) 27.1 15.0 to 49.0 11.1 6.2 to 19.9
Dialysis IGRA 3.4 1.1 to 10.7 7.0 0.7 to 67.0
TST (5 mm) 11.8 0.7 to 201.0 1.5 0.7 to 3.3
TST (10 mm) 100.8 42.1 to 243.0 2.6 1.4 to 4.8
Transplant recipients IGRA 6.7 2.2 to 20.4 2.5 1.0 to 6.0
TST (5 mm) 1.0 0 to 64.0 0.6 0.1 to 3.0
TST (10 mm) 3.7 0 to 862.0 2.4 0.9 to 6.4
Other immunocompromising conditions IGRA 4.8 0.1 to 279.0 48.1 5.4 to 431.0
TST (5 mm) 5.4 1.8 to 16.9 6.6 1.8 to 24.2
The table summarizes data from a meta-analysis including 122 studies and 116,197 participants with a positive latent TB test (IGRA or TST). In general, among individuals with a given risk factor, those with positive IGRA had higher rates of active TB than those with positive TST, likely reflecting greater specificity of IGRA. Notably, the incidence rate ratios were 11.0 in patients with HIV infection regardless of LTBI test, underscoring the value of LTBI screening in this population.
TB: tuberculosis; TST: tuberculin skin test; IGRA: interferon-gamma release assay; LTBI: latent TB infection.
Data from: Campbell JR, Winters N, Menzies D. Absolute risk of tuberculosis among untreated populations with a positive tuberculin skin test or interferon-gamma release assay result: systematic review and meta-analysis. BMJ 2020; 368:m549.
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