新しい迅速検査で潜在性結核のスクリーニングを改善(Point-of-care rapid tests can improve screening for latent tuberculosis)

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2025-11-27 カロリンスカ研究所(KI)

スウェーデンのカロリンスカ研究所(KI)を中心とする国際研究チームは、潜在性結核感染(LTBI)のスクリーニングにおいて、従来の血液検査(IGRA)に加え、医療現場で迅速に実施できるポイント・オブ・ケア(POC)型の迅速検査を組み合わせることで、感染者の特定効率を大幅に高められることを示した。カナダ・ハイチ・インドの3カ国で約3,000名を対象に評価したところ、POC検査は安価で数分以内に判定が出るため、結果が返って来ない「検査離脱」を減らし治療開始率を向上させる効果が明らかになった。特に医療アクセスが限られる地域では、血液採取や実験室設備を必要としないPOC検査が有用で、LTBI対策のボトルネック解消に貢献するとしている。研究者らは、世界的な結核対策の強化に向け、POCを含む多層的スクリーニング戦略の導入を提言している。

<関連情報>

ベトナムにおける結核感染症に対するSTANDARD F TB-Feron FIAアッセイの診断精度:横断的研究 Diagnostic Accuracy of the STANDARD F TB-Feron FIA Assay for Tuberculosis Infection in Vietnam: A Cross-Sectional Study

Han Thi Nguyen, Luan Nguyen Quang Vo, Andrew James Codlin, Rachel Forse, Tom Wingfield, Kristi Sidney Annerstedt, Emily Lai-Ho MacLean, Jacob Creswell, Beatrice Kirubi, Hoa Binh Nguyen …
Clinical Infectious Diseases  Published:26 November 2025
DOI:https://doi.org/10.1093/cid/ciaf561

新しい迅速検査で潜在性結核のスクリーニングを改善(Point-of-care rapid tests can improve screening for latent tuberculosis)
Graphical Abstrac

Abstract

Background

Tuberculosis (TB) infection is a driver of the global TB epidemic. Accurate, affordable, and simpler diagnostics are crucial for identifying people for preventive therapy. We evaluated the diagnostic performance of the STANDARD F TB-Feron FIA (TB-Feron), a near-point-of-care (POC) assay for detecting TB infection.

Methods

From June to December 2024, we conducted a cross-sectional study at the Vietnam National Lung Hospital, enrolling 352 participants, including 345 eligible participants: 95 with microbiologically confirmed pulmonary TB (Group 1), 200 household contacts of people with pulmonary TB (Group 2), and 50 with a recent history of a negative QFT-Plus result and no known TB exposure (Group 3). Participants were tested with TB-Feron and the reference standard, QuantiFERON TB Gold Plus (QFT-Plus). Results were compared for sensitivity and specificity (primary endpoints), with inter-test agreement (Cohen’s κ) and reproducibility (Bland–Altman analysis) as secondary outcomes.

Results

Among 345 eligible participants, TB-Feron sensitivity was 88.4% (95% confidence interval [CI] 80.2–94.1) in Group 1, and specificity was 70.0% (55.4–82.1) in Group 3. In Group 2, positive and negative agreements with QFT-Plus were 89.2% (79.8–95.2%) and 75.4% (66.9–82.6), respectively, with inter-test agreement of 80.5% (Cohen’s κ=0.6069, P < .0001). Intra-test reproducibility showed no significant differences in IFN-γ levels (mean difference = 2.08 IU/mL, 95% CI -1.28 to 5.44, P = .206).

Conclusions

With high sensitivity, the TB-Feron assay is a potential near-POC alternative to the QFT-Plus assay for diagnosing TB infection, but requires consideration of its suboptimal specificity.

医療・健康
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