CHEST Guidelines-Relevance-of-Serial-Interferon-γ-Release-Ass

Relevance-of-Serial-Interferon-γ-Release-Ass_31

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The document contains correspondence regarding studies on interferon-gamma (IFN-g) release assays (IGRAs) for diagnosing Mycobacterium tuberculosis (MTB) infection among healthcare workers and the seasonality of obstructive sleep apnea (OSA). Dr. Deepak Aggarwal and colleagues comment on a study by Park et al. that evaluated serial IGRAs, highlighting concerns about frequent false positives due to unexplained fluctuations in IFN-g levels. They suggest that results from monthly tests may be unreliable and call for follow-up data on IGRA-positive cases to see who develops active tuberculosis, which could inform guidelines for managing latent and active TB. They also inquire about the causes of IGRA reversion post-chemoprophylaxis, encouraging clarification on whether changes in IFN-g response are linked to infection progress.<br /><br />In response, Dr. Jong Sun Park and colleagues thank Aggarwal for his interest and address the concerns, stating that no participant with a positive IGRA has progressed to active TB yet, but long-term follow-up is required to understand the negative conversion meaning of IGRA.<br /><br />Another part of the correspondence from Felipe Ramos-Xavier and colleagues discusses a study by Cassol et al. about whether OSA severity varies with seasonality, especially in winter. They appreciate the extensive analysis conducted but note the study's limitation to a single location (Porto Alegre, Brazil), which may not represent universal trends. They propose a need for multicentric research in diverse climates to understand sleep disorder seasonality better.<br /><br />Overall, these letters emphasize the importance of thoroughly understanding the dynamics of MTB diagnosis in healthcare workers using IGRAs and exploring the seasonality impacts on sleep disorders, advocating for broader, more inclusive studies in diverse geographical settings.

Keywords

interferon-gamma

IGRAs

Mycobacterium tuberculosis

healthcare workers

sleep apnea seasonality

false positives

latent TB

chemoprophylaxis

multicentric research

geographical diversity