TUBERCULIN DIAGNOSTICS: HISTORY AND PROSPECTS
In the review, the characteristics of tuberculin preparations and the results of their long-term use are given. It has been shown that in the conditions of mass vaccination of BCG and the spread of HIV infection with high sensitivity, the diagnostic value of these preparations is significantly reduced. The isolation of “virulence antigens” from virulent Mycobacterium tuberculosis (absent in BCG) led to the creation and application in the last 10 years of new tests and preparations for the diagnosis of tuberculosis, including its latent form. There are in vitro tests (IGRA tests) based on the determination of the content of interferon-gamma or sensitized lymphocytes of its excretory in an infected or infected person with tuberculosis. Despite the high sensitivity and specificity of these tests, due to their high cost and other disadvantages, they are not applicable for mass screening. The solution to the problem was the creation of a new tuberculin - allergen of tuberculous recombinant (Diaskintest®), consisting of ESAT6-CFP10 protein. Analysis of the results of a large-scale marketing study of this allergen showed its high specificity, which allowed to recommend a diaskintest for mass tuberculin diagnostics in place of purified tuberculin in children older than 7 years. The prospect of increasing the sensitivity of the allergen of a tuberculous recombinant may include the inclusion of other antigens present in the preparation of virulent mycobacterium of tuberculosis.