Key areas of future research with respect to new TB infection diagnostic tests should address the major limitations of the TST and IGRA. Development of tests that don’t require lab infrastructure or a second visit for reading and that also overcome specificity limitations of the TST would make testing more accessible. Furthermore, tests or biomarker signatures that are more predictive for TB disease than the TST and IGRA are needed. Tests that identify those most likely to benefit from TPT would increase the benefit of treatment while substantially reducing the number of persons who would be exposed to the risks of treatment. As the two currently available TB infection diagnostics, the TST and IGRA, are not highly predictive for TB disease, more prospective research is required to improve decision-making surrounding which test to use, at which positive cut-point and in which population, to maximize individual benefits of treatment.
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