Aspectos críticos do uso prático do teste in vitro para o diagnóstico da Tuberculose Humana: revisão sistemática

Abstract

Critical Aspects of the Practical Use of the In Vitro Test for the Diagnosis of Human Tuberculosis. Introduction: Tuberculosis (TB) is an infectious disease that represents a serious public health problem. In 2013, according to the World Health Organization (WHO), 9 million new TB cases were recorded and 1.5 million deaths worldwide. About one-third of the global population has the latent form of infection with the Mycobacterium tuberculosis complex that is widely diffused as Koch's Bacillus (BK). In latent infection there is a risk of activation of the disease, causing the individual to become bacilliferous, thus being a BK transmitter. Diagnosis up to the last decade has been made throughout the world by tuberculin skin test (TST), an in vivo immunodiagnostic method. In 2015, however, ANVISA authorized the use of the Interferon Gamma Release Assay (IGRA) test for the diagnosis of in vitro tuberculosis in Brazil, after the first two years of research. Objective: To evaluate technical and practical aspects, advantages and disadvantages of IGRA tests in the diagnosis of tuberculosis / latent infection. Methodology: This is a systematic review on the subject. Scientific articles published in the English language, from 2007 to 2016, were available in the PubMed / MEDLINE database, with the descriptors: "igra test and latent tuberculosis", "tuberculin skin test", "BK" and "latent tuberculosis" Boolean operators "AND and OR" were used. Results: We initially found 340 articles that were chosen by the abstract and title and of those by the inclusion and exclusion criteria, 16 articles were selected for critical analysis. Conclusion: Igra has the advantage of not interfering with BCG vaccination, it does not require patient feedback for reading. It has as main fragile point the cost that is still very high in comparison with the TST.