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As of 2003, the enzyme-linked immunospot assay (ELISPOT) has been another blood test available in the UK that may replace the skin test for diagnosis. [ 20 ] [ 21 ] [ 22 ] T-SPOT.TB , [ 23 ] a type of ELISpot Assay , [ 24 ] counts the number of activated T lymphocytes that secrete interferon γ.
T-SPOT.TB counts the number of antimycobacterial effector T cells, white blood cells that produce interferon-gamma, in a sample of blood.This gives an overall measurement of the host immune response against mycobacteria, which can reveal the presence of infection with Mycobacterium tuberculosis, the causative agent of tuberculosis (TB).
The first test is read 48–72 hours after injection. If the first test is positive, consider the person infected. If the first test is negative, give a second test one to three weeks after the first injection. The second test is read 48–72 hours after injection. If the second test is positive, consider the person infected in the distant past ...
The test used in the United States at present is referred to as the Mantoux test. An alternative test called the Heaf test was used in the United Kingdom until 2005, although the UK now uses the Mantoux test in line with the rest of the world. Both of these tests use the tuberculin derivative PPD (purified protein derivative).
The UK guidelines are formulated according to the Heaf test: In patients who have had BCG previously, latent TB is diagnosed if the Heaf test is grade 3 or 4 and have no signs or symptoms of active TB; if the Heaf test is grade 0 or 1, then the test is repeated.
The equivalent Mantoux test positive levels done with 10 TU (0.1 mL 100 TU/mL, 1:1000) are 0–4 mm induration (Heaf 0-1) 5–14 mm induration (Heaf 2) >15 mm induration (Heaf 3-4) The Mantoux test is preferred in the United States for the diagnosis of tuberculosis; multiple puncture tests, such as the Heaf test and Tine test, are not recommended.
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The tine test is a multiple-puncture tuberculin skin test used to aid in the medical diagnosis of tuberculosis (TB). The tine test is similar to the Heaf test, although the Mantoux test is usually used instead. There are various forms of the tine tests which usually fall into two categories: the old tine test (OT) and the purified protein ...
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