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July 18, 2012

Is It Time to Replace the Tuberculin Skin Test With a Blood Test?

Author Affiliations

Author Affiliations: Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.

JAMA. 2012;308(3):241-242. doi:10.1001/jama.2012.7511

Effective diagnosis and treatment of latent tuberculosis infection (LTBI) to prevent progression to tuberculosis (TB) disease is one of the priority strategies for control, prevention, and eventual elimination of TB in the United States. Recent mathematical TB transmission modeling has shown that substantial improvements in addressing LTBI will be needed to eliminate TB before the 22nd century.1 Effective management of LTBI has been hampered by limitations of both treatment regimens and diagnostic tools. The advent of medication regimens with much shorter durations (eg, 12 weekly doses of isoniazid and rifapentine) than the current standard of 9 months of isoniazid is likely to lead to higher rates of treatment completion. Efforts have also been directed at finding a replacement for the tuberculin skin test (TST), which despite its many limitations has been the mainstay of LTBI diagnosis.