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Davidow AL – As a result of the markedly dissimilar health statuses associated with a negative LTBI test, IGRA specificity for LTBI and sensitivity to active TB depend upon TB and LTBI prevalence. A trade–off exists between the specificity of IGRAs to LTBI and sensitivity to active TB. Field studies of IGRAs will require standardized collection of symptoms of active TB to distinguish LTBI suspects from TB suspects. Different cut–off points for IGRA use in TB suspects and LTBI suspects will likely be needed.

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