| First Author, Publication Year [reference number] . | Country (TB- endemicity)a . | Setting . | Design . | Definition of Lesions Suggestive of Past TB . | Case Definition (Criterion for LTBI) . | N Subjects . | Ageb . | Sex (% male) . | Individuals with LTBI and Lesions on CXR N/N with LTBI (%) . | Uninfected Controls With Lesions on CXR N/N Controls (%) . |
|---|---|---|---|---|---|---|---|---|---|---|
| Studies with control group | ||||||||||
| Bonfiglioli, 2014 [28] | Brazil (high) | Anti-TNF screening | Cohort | Signs of previous TB (fibrotic lesions)/TB sequelae. | TST ≥ 5 mm | 202 | 52 ± 11 | 16.8 | 6/44 (13.6) | 8/158 (5.1) |
| Christopoulos, 2009 [29] | Greece (low) | Screening HD/PD | Cohort | Dense pulmonary nodules, with or without visible calcification, in the hilar area or upper lobes, smaller nodules with or without fibrotic scars in the upper lobes, accompanied with upper lobe volume loss bronchiectasis of the upper lobe and/or pleural scarring. | TST ≥ 10 mm | 272 | 25–77 | 71.0 | 27/62 (43.5) | 40/210 (19.0) |
| Costantino, 2013 [30] | France (low) | Anti-TNF screening | Cross-sectional | Suggestive of previous TB infection (pulmonary nodules, upper lobe bronchiectasis, apical pleural thickening, interstitial granulomatous calcifications, cavitations, and lymph node or pericardial calcifications). | TST ≥ 5 mm T-SPOT+ TST ≥ 5 mm and T-SPOT+ | 196 122 279 | 51.0 NR NR | 53.1 44.3 38.4 | 14/196 (7.1) 13/122 (10.7) 9/59 (15.3) | NA NA 2/220 (0.9) |
| Foster, 2016 [31] | Canada (low) | Screening HD/PD | Cohort | Evidence of previous TB infection (including infiltrates, tissue loss, and cavitations upper lobe). | TST ≥ 5 mm TST ≥ 10 mm | 476 465 | 62 ± 11 62 ± 11 | 49.1 49.1 | 14/62 (22.6) 12/43 (27.9) | 107/406 (25.4) 89/422 (21.1) |
| Jeong, 2012 [32] | South Korea (high) | Routine CXR | Case control | Old, healed TB (calcified nodular densities, fibrosis/nodular densities, basal pleural thickening ≥10mm, and bronchiectasis upper lobe). | TST ≥ 10 mm QFT+ | 271 319 | 18–88 18–88 | NR 58.6 | 89/131 (67.9) 150/228 (65.8) | 74/140 (52.9) 43/91 (47.3) |
| Joshi, 2007 [33] | India (high) | Screening HCW | Cross-sectional | Suggestive of inactive TB (fibrotic scar [with volume loss], [non-] calcified nodules [with volume loss], bronchiectasis, pleural thickening, diaphragmatic tenting, and blunt costophrenic angle. | TST ≥ 10 mm QFT+ TST ≥ 10 mm and QFT+ | 276 328 209 | 32 ± 12 NR NR | NR NR NR | 174/276 (63.0) 163/261 (62.5) 131/209 (62.7) | NA 43/67 (64.2) NA |
| Katsenos, 2011 [34] | Greece (low) | Contact investigation | Cross-sectional | Abnormal findings (fibrotic-appearing apical lesions). | TST ≥ 5 mm | 77 | 75 | 15.6 | 0/26 (0) | 6/51 (11.8) |
| Kim, 2010 [35] | South Korea (high) | Pre-transplant screening | Cohort | Abnormal findings suggestive of inactive TB. | TST ≥ 5 mm TST ≥ 10 mm T-SPOT+ | 209 209 184 | NR NR NR | NR NR NR | 5/47 (10.6) 3/21 (14.3) 5/65 (7.7) | 5/162 (3.1) 7/188 (3.7) 4/119 (3.4) |
| Kleinert, 2012 [36] | Germany (low) | Anti-TNF screening | Cross-sectional | Lesions suggestive of latent or prior TB. | TST ≥ 5 mm QFT+ T-SPOT+ TST ≥ 5 mm and IGRA+ | 1529 685 844 1368 | NR NR NR NR | 38.7 NR NR 37.9 | 15/173 (8.7) 3/50 (6.0) 15/70 (21.4) 13/66 (19.7) | 12/1356 (0.9) 7/635 (1.1) 2/777 (0.3) 7/1302 (0.5) |
| Roelsgaard, 1961 [37] | Kenya (high) | Population study | Cross-sectional | Infiltrate with cavity, infiltrate without cavity, calcified or fibrotic lesions, and pleural adhesions. Where more than 1 shadow was seen, the classification into type of lesion was determined by the most “severe“ finding. | TST ≥ 10 mm | 4946 | NR | NR | 231/2475 (9.3) | 82/2471 (3.3) |
| Seyhan, 2009 [38] | Turkey (low) | Screening HD/PD | Cross-sectional | TB scar lesions (dense pulmonary nodules with/without calcification in hilar area or upper lobes, and pleural thickening). | TST ≥ 10 mm QFT+ | 100 100 | 56 ± 15 56 ± 15 | 47.0 47.0 | 4/34 (11.8) 11/43 (25.6) | 12/66 (18.2) 5/57 (8.8) |
| Sichletidis, 2006 [39] | Greece (low) | Anti-TNF screening | Cohort | An abnormal CXR suggesting latent TB (apical fibrotic lesions and pleural calcification). | TST ≥ 10 mm | 613 | 49 ± 8 | 32.1 | 5/45 (11.1) | 0/568 (0) |
| Tafuri, 2011 [40] | Italy (low) | Immigrant screening | Cross-sectional | TB sequelae. | TST+ | 669 | 25 | NR | 99/554 (17.9) | 16/115 (13.9) |
| Triverio, 2009 [41] | Switzerland (low) | Immigrant screening | Cohort | Suggestive of prior TB. | TST ≥ 5 mm | 62 | 65 ± 15 | 74.2 | 2/12 (16.7) | 6/50 (12.0) |
| QFT+ | 57 | NR | NR | 3/13 (23.1) | 5/44 (11.4) | |||||
| T-SPOT+ | 55 | NR | NR | 1/18 (5.6) | 5/37 (13.5) | |||||
| Vassilopoulos, 2009 [42] | Greece (low) | Anti-TNF screening | Cohort | Suggestive of previous, inactive TB (calcified or noncalcified nodules or fibrotic scars). | TST ≥ 5 mm | 155 | 52 ± 16 | 41.9 | 9/58 (15.5) | 5/97 (5.2) |
| QFT+ | 155 | 52 ± 16 | 41.9% | 4/32 (12.5) | 10/123 (8.1) | |||||
| T-SPOT+ | 155 | 52 ± 16 | 41.9 | 4/39 (10.3) | 10/116 (8.6) | |||||
| Wauters, 2004 [43] | Belgium (low) | Screening HD/PD | Cross-sectional | TB lesions: dense pulmonary nodules with or without visible calcification in the hilar area or upper lobes or pleural scarring were scored as positive findings. | TST ≥ 10 mm | 224 | 68 ± 13 | 58.0 | 22/73 (30.1) | 34/151 (22.5) |
| Studies without control group | ||||||||||
| Bailey, 1977 [18] | United States (low) | Routine CXR | Cohort | Consistent with old TB. | TST+ | 1524 | NR | NR | 61/1524 (4.0) | NA |
| Eisenberg, 2009 [19] | United States (low) | Pre-employment | Cross-sectional | Abnormalities suggestive of chronic TB infection (calcified granulomas and lymph nodes, apical pleural thickening, fibrosis, and nodules). | TST ≥ 10 mm | 875 | 18–65 | 44.8 | 91/875 (10.4) | NA |
| Eisenberg, 2010 [20] | United States (low) | Pre-employment | Cross-sectional | Evidence of prior TB infection included apical or basal pleural thickening; fibrous scarring; calcified granulomas and/or, calcified lymph nodes; and noncalcified nodules. | TST ≥ 10 mm TST ≥ 10 mm and QFT+ | 2586 | 18–65 | 45.0 | 159/2586 (6.1) 8/135 (5.9) | NA NA |
| Eisenberg, 2017 [21] | United States (low) | Routine CXR | Cohort | Evidence of prior TB infection (apical pleural thickening, fibrous scarring, calcified granulomas/lymph nodes and noncalcified nodules). | TST ≥ 10 mm | 2518 | 18–93 | 38.9 | 196/2518 (7.8) | NA |
| Gershon, 2004 [22] | Canada (low) | TB clinic | Cohort | Abnormal findings consistent with previous TB. | TST ≥ 10 mm or TST ≥ 5 mm | 308 | NR | 56.8 | 77/308 (25.0) | NA |
| Gottridge, 1989 [23] | Unites States (low) | Screening HCW | Cohort | Apical pleural thickening, active parenchymal lesion, cavitating lesion, pleural effusion, fibrocalcific disease, unrelated abnormality, or other abnormal CXR findings consistent with previous TB. | TST ≥ 10 mm | 221 | 18–65 | 33.9 | 9/221 (4.1) | NA |
| Kunimoto, 2009 [24] | Canada (low) | Routine CXR | Cross-sectional | Findings suggestive of previous TB (TB scar). | TST ≥ 5 mm TST ≥ 5 mm and QFT+ | 1446 566 | NR 32 ± 16c | 37.5 41.7 | 304/1446 (21.0) 170/566 (30.0) | NA NA |
| Manadan, 2007 [25] | United States (low) | Anti-TNF screening | Cohort | Evidence of old granulomatous disease. | TST ≥ 10 mm | 43 | NR | NR | 10/43 (23.2) | NA |
| Meyer, 2003 [26] | United States (low) | Routine CXR | Cross-sectional | Lesions suggestive of tuberculosis infection abnormal, fibrosis, granuloma, consolidation or cavity, pleural disease, and calcified lymph nodes. | TST+ | 535 | 39 ± 15 | 48 | 75/535 (14.0) | NA |
| Nolan, 1988 [27] | United States (low) | Immigrant screening | Cohort | Abnormal CXRs consistent with inactive TB. | TST ≥ 10 mm | 3300 | NR | NR | 185/3300 (5.6) | NA |
| First Author, Publication Year [reference number] . | Country (TB- endemicity)a . | Setting . | Design . | Definition of Lesions Suggestive of Past TB . | Case Definition (Criterion for LTBI) . | N Subjects . | Ageb . | Sex (% male) . | Individuals with LTBI and Lesions on CXR N/N with LTBI (%) . | Uninfected Controls With Lesions on CXR N/N Controls (%) . |
|---|---|---|---|---|---|---|---|---|---|---|
| Studies with control group | ||||||||||
| Bonfiglioli, 2014 [28] | Brazil (high) | Anti-TNF screening | Cohort | Signs of previous TB (fibrotic lesions)/TB sequelae. | TST ≥ 5 mm | 202 | 52 ± 11 | 16.8 | 6/44 (13.6) | 8/158 (5.1) |
| Christopoulos, 2009 [29] | Greece (low) | Screening HD/PD | Cohort | Dense pulmonary nodules, with or without visible calcification, in the hilar area or upper lobes, smaller nodules with or without fibrotic scars in the upper lobes, accompanied with upper lobe volume loss bronchiectasis of the upper lobe and/or pleural scarring. | TST ≥ 10 mm | 272 | 25–77 | 71.0 | 27/62 (43.5) | 40/210 (19.0) |
| Costantino, 2013 [30] | France (low) | Anti-TNF screening | Cross-sectional | Suggestive of previous TB infection (pulmonary nodules, upper lobe bronchiectasis, apical pleural thickening, interstitial granulomatous calcifications, cavitations, and lymph node or pericardial calcifications). | TST ≥ 5 mm T-SPOT+ TST ≥ 5 mm and T-SPOT+ | 196 122 279 | 51.0 NR NR | 53.1 44.3 38.4 | 14/196 (7.1) 13/122 (10.7) 9/59 (15.3) | NA NA 2/220 (0.9) |
| Foster, 2016 [31] | Canada (low) | Screening HD/PD | Cohort | Evidence of previous TB infection (including infiltrates, tissue loss, and cavitations upper lobe). | TST ≥ 5 mm TST ≥ 10 mm | 476 465 | 62 ± 11 62 ± 11 | 49.1 49.1 | 14/62 (22.6) 12/43 (27.9) | 107/406 (25.4) 89/422 (21.1) |
| Jeong, 2012 [32] | South Korea (high) | Routine CXR | Case control | Old, healed TB (calcified nodular densities, fibrosis/nodular densities, basal pleural thickening ≥10mm, and bronchiectasis upper lobe). | TST ≥ 10 mm QFT+ | 271 319 | 18–88 18–88 | NR 58.6 | 89/131 (67.9) 150/228 (65.8) | 74/140 (52.9) 43/91 (47.3) |
| Joshi, 2007 [33] | India (high) | Screening HCW | Cross-sectional | Suggestive of inactive TB (fibrotic scar [with volume loss], [non-] calcified nodules [with volume loss], bronchiectasis, pleural thickening, diaphragmatic tenting, and blunt costophrenic angle. | TST ≥ 10 mm QFT+ TST ≥ 10 mm and QFT+ | 276 328 209 | 32 ± 12 NR NR | NR NR NR | 174/276 (63.0) 163/261 (62.5) 131/209 (62.7) | NA 43/67 (64.2) NA |
| Katsenos, 2011 [34] | Greece (low) | Contact investigation | Cross-sectional | Abnormal findings (fibrotic-appearing apical lesions). | TST ≥ 5 mm | 77 | 75 | 15.6 | 0/26 (0) | 6/51 (11.8) |
| Kim, 2010 [35] | South Korea (high) | Pre-transplant screening | Cohort | Abnormal findings suggestive of inactive TB. | TST ≥ 5 mm TST ≥ 10 mm T-SPOT+ | 209 209 184 | NR NR NR | NR NR NR | 5/47 (10.6) 3/21 (14.3) 5/65 (7.7) | 5/162 (3.1) 7/188 (3.7) 4/119 (3.4) |
| Kleinert, 2012 [36] | Germany (low) | Anti-TNF screening | Cross-sectional | Lesions suggestive of latent or prior TB. | TST ≥ 5 mm QFT+ T-SPOT+ TST ≥ 5 mm and IGRA+ | 1529 685 844 1368 | NR NR NR NR | 38.7 NR NR 37.9 | 15/173 (8.7) 3/50 (6.0) 15/70 (21.4) 13/66 (19.7) | 12/1356 (0.9) 7/635 (1.1) 2/777 (0.3) 7/1302 (0.5) |
| Roelsgaard, 1961 [37] | Kenya (high) | Population study | Cross-sectional | Infiltrate with cavity, infiltrate without cavity, calcified or fibrotic lesions, and pleural adhesions. Where more than 1 shadow was seen, the classification into type of lesion was determined by the most “severe“ finding. | TST ≥ 10 mm | 4946 | NR | NR | 231/2475 (9.3) | 82/2471 (3.3) |
| Seyhan, 2009 [38] | Turkey (low) | Screening HD/PD | Cross-sectional | TB scar lesions (dense pulmonary nodules with/without calcification in hilar area or upper lobes, and pleural thickening). | TST ≥ 10 mm QFT+ | 100 100 | 56 ± 15 56 ± 15 | 47.0 47.0 | 4/34 (11.8) 11/43 (25.6) | 12/66 (18.2) 5/57 (8.8) |
| Sichletidis, 2006 [39] | Greece (low) | Anti-TNF screening | Cohort | An abnormal CXR suggesting latent TB (apical fibrotic lesions and pleural calcification). | TST ≥ 10 mm | 613 | 49 ± 8 | 32.1 | 5/45 (11.1) | 0/568 (0) |
| Tafuri, 2011 [40] | Italy (low) | Immigrant screening | Cross-sectional | TB sequelae. | TST+ | 669 | 25 | NR | 99/554 (17.9) | 16/115 (13.9) |
| Triverio, 2009 [41] | Switzerland (low) | Immigrant screening | Cohort | Suggestive of prior TB. | TST ≥ 5 mm | 62 | 65 ± 15 | 74.2 | 2/12 (16.7) | 6/50 (12.0) |
| QFT+ | 57 | NR | NR | 3/13 (23.1) | 5/44 (11.4) | |||||
| T-SPOT+ | 55 | NR | NR | 1/18 (5.6) | 5/37 (13.5) | |||||
| Vassilopoulos, 2009 [42] | Greece (low) | Anti-TNF screening | Cohort | Suggestive of previous, inactive TB (calcified or noncalcified nodules or fibrotic scars). | TST ≥ 5 mm | 155 | 52 ± 16 | 41.9 | 9/58 (15.5) | 5/97 (5.2) |
| QFT+ | 155 | 52 ± 16 | 41.9% | 4/32 (12.5) | 10/123 (8.1) | |||||
| T-SPOT+ | 155 | 52 ± 16 | 41.9 | 4/39 (10.3) | 10/116 (8.6) | |||||
| Wauters, 2004 [43] | Belgium (low) | Screening HD/PD | Cross-sectional | TB lesions: dense pulmonary nodules with or without visible calcification in the hilar area or upper lobes or pleural scarring were scored as positive findings. | TST ≥ 10 mm | 224 | 68 ± 13 | 58.0 | 22/73 (30.1) | 34/151 (22.5) |
| Studies without control group | ||||||||||
| Bailey, 1977 [18] | United States (low) | Routine CXR | Cohort | Consistent with old TB. | TST+ | 1524 | NR | NR | 61/1524 (4.0) | NA |
| Eisenberg, 2009 [19] | United States (low) | Pre-employment | Cross-sectional | Abnormalities suggestive of chronic TB infection (calcified granulomas and lymph nodes, apical pleural thickening, fibrosis, and nodules). | TST ≥ 10 mm | 875 | 18–65 | 44.8 | 91/875 (10.4) | NA |
| Eisenberg, 2010 [20] | United States (low) | Pre-employment | Cross-sectional | Evidence of prior TB infection included apical or basal pleural thickening; fibrous scarring; calcified granulomas and/or, calcified lymph nodes; and noncalcified nodules. | TST ≥ 10 mm TST ≥ 10 mm and QFT+ | 2586 | 18–65 | 45.0 | 159/2586 (6.1) 8/135 (5.9) | NA NA |
| Eisenberg, 2017 [21] | United States (low) | Routine CXR | Cohort | Evidence of prior TB infection (apical pleural thickening, fibrous scarring, calcified granulomas/lymph nodes and noncalcified nodules). | TST ≥ 10 mm | 2518 | 18–93 | 38.9 | 196/2518 (7.8) | NA |
| Gershon, 2004 [22] | Canada (low) | TB clinic | Cohort | Abnormal findings consistent with previous TB. | TST ≥ 10 mm or TST ≥ 5 mm | 308 | NR | 56.8 | 77/308 (25.0) | NA |
| Gottridge, 1989 [23] | Unites States (low) | Screening HCW | Cohort | Apical pleural thickening, active parenchymal lesion, cavitating lesion, pleural effusion, fibrocalcific disease, unrelated abnormality, or other abnormal CXR findings consistent with previous TB. | TST ≥ 10 mm | 221 | 18–65 | 33.9 | 9/221 (4.1) | NA |
| Kunimoto, 2009 [24] | Canada (low) | Routine CXR | Cross-sectional | Findings suggestive of previous TB (TB scar). | TST ≥ 5 mm TST ≥ 5 mm and QFT+ | 1446 566 | NR 32 ± 16c | 37.5 41.7 | 304/1446 (21.0) 170/566 (30.0) | NA NA |
| Manadan, 2007 [25] | United States (low) | Anti-TNF screening | Cohort | Evidence of old granulomatous disease. | TST ≥ 10 mm | 43 | NR | NR | 10/43 (23.2) | NA |
| Meyer, 2003 [26] | United States (low) | Routine CXR | Cross-sectional | Lesions suggestive of tuberculosis infection abnormal, fibrosis, granuloma, consolidation or cavity, pleural disease, and calcified lymph nodes. | TST+ | 535 | 39 ± 15 | 48 | 75/535 (14.0) | NA |
| Nolan, 1988 [27] | United States (low) | Immigrant screening | Cohort | Abnormal CXRs consistent with inactive TB. | TST ≥ 10 mm | 3300 | NR | NR | 185/3300 (5.6) | NA |
Abbreviations: CXR, chest radiography; HCW, healthcare workers; HD/PD, hemodialysis/peritoneal dialysis; IGRA, interferon gamma release assay; LTBI, latent tuberculosis infection; NA, not applicable; NR, not reported; QFT, QuantiFERON Gold in-tube; TB, tuberculosis; TNF, tumor necrosis factor; T-SPOT, T-SPOT.TB; TST, tuberculin skin test.
a TB-endemicity was considered high in case of ≥40 cases of active TB/100 000 inhabitants per year.
b Mean (± standard deviation, if available) or range; median used only if mean or range were not described.
c Median.
| First Author, Publication Year [reference number] . | Country (TB- endemicity)a . | Setting . | Design . | Definition of Lesions Suggestive of Past TB . | Case Definition (Criterion for LTBI) . | N Subjects . | Ageb . | Sex (% male) . | Individuals with LTBI and Lesions on CXR N/N with LTBI (%) . | Uninfected Controls With Lesions on CXR N/N Controls (%) . |
|---|---|---|---|---|---|---|---|---|---|---|
| Studies with control group | ||||||||||
| Bonfiglioli, 2014 [28] | Brazil (high) | Anti-TNF screening | Cohort | Signs of previous TB (fibrotic lesions)/TB sequelae. | TST ≥ 5 mm | 202 | 52 ± 11 | 16.8 | 6/44 (13.6) | 8/158 (5.1) |
| Christopoulos, 2009 [29] | Greece (low) | Screening HD/PD | Cohort | Dense pulmonary nodules, with or without visible calcification, in the hilar area or upper lobes, smaller nodules with or without fibrotic scars in the upper lobes, accompanied with upper lobe volume loss bronchiectasis of the upper lobe and/or pleural scarring. | TST ≥ 10 mm | 272 | 25–77 | 71.0 | 27/62 (43.5) | 40/210 (19.0) |
| Costantino, 2013 [30] | France (low) | Anti-TNF screening | Cross-sectional | Suggestive of previous TB infection (pulmonary nodules, upper lobe bronchiectasis, apical pleural thickening, interstitial granulomatous calcifications, cavitations, and lymph node or pericardial calcifications). | TST ≥ 5 mm T-SPOT+ TST ≥ 5 mm and T-SPOT+ | 196 122 279 | 51.0 NR NR | 53.1 44.3 38.4 | 14/196 (7.1) 13/122 (10.7) 9/59 (15.3) | NA NA 2/220 (0.9) |
| Foster, 2016 [31] | Canada (low) | Screening HD/PD | Cohort | Evidence of previous TB infection (including infiltrates, tissue loss, and cavitations upper lobe). | TST ≥ 5 mm TST ≥ 10 mm | 476 465 | 62 ± 11 62 ± 11 | 49.1 49.1 | 14/62 (22.6) 12/43 (27.9) | 107/406 (25.4) 89/422 (21.1) |
| Jeong, 2012 [32] | South Korea (high) | Routine CXR | Case control | Old, healed TB (calcified nodular densities, fibrosis/nodular densities, basal pleural thickening ≥10mm, and bronchiectasis upper lobe). | TST ≥ 10 mm QFT+ | 271 319 | 18–88 18–88 | NR 58.6 | 89/131 (67.9) 150/228 (65.8) | 74/140 (52.9) 43/91 (47.3) |
| Joshi, 2007 [33] | India (high) | Screening HCW | Cross-sectional | Suggestive of inactive TB (fibrotic scar [with volume loss], [non-] calcified nodules [with volume loss], bronchiectasis, pleural thickening, diaphragmatic tenting, and blunt costophrenic angle. | TST ≥ 10 mm QFT+ TST ≥ 10 mm and QFT+ | 276 328 209 | 32 ± 12 NR NR | NR NR NR | 174/276 (63.0) 163/261 (62.5) 131/209 (62.7) | NA 43/67 (64.2) NA |
| Katsenos, 2011 [34] | Greece (low) | Contact investigation | Cross-sectional | Abnormal findings (fibrotic-appearing apical lesions). | TST ≥ 5 mm | 77 | 75 | 15.6 | 0/26 (0) | 6/51 (11.8) |
| Kim, 2010 [35] | South Korea (high) | Pre-transplant screening | Cohort | Abnormal findings suggestive of inactive TB. | TST ≥ 5 mm TST ≥ 10 mm T-SPOT+ | 209 209 184 | NR NR NR | NR NR NR | 5/47 (10.6) 3/21 (14.3) 5/65 (7.7) | 5/162 (3.1) 7/188 (3.7) 4/119 (3.4) |
| Kleinert, 2012 [36] | Germany (low) | Anti-TNF screening | Cross-sectional | Lesions suggestive of latent or prior TB. | TST ≥ 5 mm QFT+ T-SPOT+ TST ≥ 5 mm and IGRA+ | 1529 685 844 1368 | NR NR NR NR | 38.7 NR NR 37.9 | 15/173 (8.7) 3/50 (6.0) 15/70 (21.4) 13/66 (19.7) | 12/1356 (0.9) 7/635 (1.1) 2/777 (0.3) 7/1302 (0.5) |
| Roelsgaard, 1961 [37] | Kenya (high) | Population study | Cross-sectional | Infiltrate with cavity, infiltrate without cavity, calcified or fibrotic lesions, and pleural adhesions. Where more than 1 shadow was seen, the classification into type of lesion was determined by the most “severe“ finding. | TST ≥ 10 mm | 4946 | NR | NR | 231/2475 (9.3) | 82/2471 (3.3) |
| Seyhan, 2009 [38] | Turkey (low) | Screening HD/PD | Cross-sectional | TB scar lesions (dense pulmonary nodules with/without calcification in hilar area or upper lobes, and pleural thickening). | TST ≥ 10 mm QFT+ | 100 100 | 56 ± 15 56 ± 15 | 47.0 47.0 | 4/34 (11.8) 11/43 (25.6) | 12/66 (18.2) 5/57 (8.8) |
| Sichletidis, 2006 [39] | Greece (low) | Anti-TNF screening | Cohort | An abnormal CXR suggesting latent TB (apical fibrotic lesions and pleural calcification). | TST ≥ 10 mm | 613 | 49 ± 8 | 32.1 | 5/45 (11.1) | 0/568 (0) |
| Tafuri, 2011 [40] | Italy (low) | Immigrant screening | Cross-sectional | TB sequelae. | TST+ | 669 | 25 | NR | 99/554 (17.9) | 16/115 (13.9) |
| Triverio, 2009 [41] | Switzerland (low) | Immigrant screening | Cohort | Suggestive of prior TB. | TST ≥ 5 mm | 62 | 65 ± 15 | 74.2 | 2/12 (16.7) | 6/50 (12.0) |
| QFT+ | 57 | NR | NR | 3/13 (23.1) | 5/44 (11.4) | |||||
| T-SPOT+ | 55 | NR | NR | 1/18 (5.6) | 5/37 (13.5) | |||||
| Vassilopoulos, 2009 [42] | Greece (low) | Anti-TNF screening | Cohort | Suggestive of previous, inactive TB (calcified or noncalcified nodules or fibrotic scars). | TST ≥ 5 mm | 155 | 52 ± 16 | 41.9 | 9/58 (15.5) | 5/97 (5.2) |
| QFT+ | 155 | 52 ± 16 | 41.9% | 4/32 (12.5) | 10/123 (8.1) | |||||
| T-SPOT+ | 155 | 52 ± 16 | 41.9 | 4/39 (10.3) | 10/116 (8.6) | |||||
| Wauters, 2004 [43] | Belgium (low) | Screening HD/PD | Cross-sectional | TB lesions: dense pulmonary nodules with or without visible calcification in the hilar area or upper lobes or pleural scarring were scored as positive findings. | TST ≥ 10 mm | 224 | 68 ± 13 | 58.0 | 22/73 (30.1) | 34/151 (22.5) |
| Studies without control group | ||||||||||
| Bailey, 1977 [18] | United States (low) | Routine CXR | Cohort | Consistent with old TB. | TST+ | 1524 | NR | NR | 61/1524 (4.0) | NA |
| Eisenberg, 2009 [19] | United States (low) | Pre-employment | Cross-sectional | Abnormalities suggestive of chronic TB infection (calcified granulomas and lymph nodes, apical pleural thickening, fibrosis, and nodules). | TST ≥ 10 mm | 875 | 18–65 | 44.8 | 91/875 (10.4) | NA |
| Eisenberg, 2010 [20] | United States (low) | Pre-employment | Cross-sectional | Evidence of prior TB infection included apical or basal pleural thickening; fibrous scarring; calcified granulomas and/or, calcified lymph nodes; and noncalcified nodules. | TST ≥ 10 mm TST ≥ 10 mm and QFT+ | 2586 | 18–65 | 45.0 | 159/2586 (6.1) 8/135 (5.9) | NA NA |
| Eisenberg, 2017 [21] | United States (low) | Routine CXR | Cohort | Evidence of prior TB infection (apical pleural thickening, fibrous scarring, calcified granulomas/lymph nodes and noncalcified nodules). | TST ≥ 10 mm | 2518 | 18–93 | 38.9 | 196/2518 (7.8) | NA |
| Gershon, 2004 [22] | Canada (low) | TB clinic | Cohort | Abnormal findings consistent with previous TB. | TST ≥ 10 mm or TST ≥ 5 mm | 308 | NR | 56.8 | 77/308 (25.0) | NA |
| Gottridge, 1989 [23] | Unites States (low) | Screening HCW | Cohort | Apical pleural thickening, active parenchymal lesion, cavitating lesion, pleural effusion, fibrocalcific disease, unrelated abnormality, or other abnormal CXR findings consistent with previous TB. | TST ≥ 10 mm | 221 | 18–65 | 33.9 | 9/221 (4.1) | NA |
| Kunimoto, 2009 [24] | Canada (low) | Routine CXR | Cross-sectional | Findings suggestive of previous TB (TB scar). | TST ≥ 5 mm TST ≥ 5 mm and QFT+ | 1446 566 | NR 32 ± 16c | 37.5 41.7 | 304/1446 (21.0) 170/566 (30.0) | NA NA |
| Manadan, 2007 [25] | United States (low) | Anti-TNF screening | Cohort | Evidence of old granulomatous disease. | TST ≥ 10 mm | 43 | NR | NR | 10/43 (23.2) | NA |
| Meyer, 2003 [26] | United States (low) | Routine CXR | Cross-sectional | Lesions suggestive of tuberculosis infection abnormal, fibrosis, granuloma, consolidation or cavity, pleural disease, and calcified lymph nodes. | TST+ | 535 | 39 ± 15 | 48 | 75/535 (14.0) | NA |
| Nolan, 1988 [27] | United States (low) | Immigrant screening | Cohort | Abnormal CXRs consistent with inactive TB. | TST ≥ 10 mm | 3300 | NR | NR | 185/3300 (5.6) | NA |
| First Author, Publication Year [reference number] . | Country (TB- endemicity)a . | Setting . | Design . | Definition of Lesions Suggestive of Past TB . | Case Definition (Criterion for LTBI) . | N Subjects . | Ageb . | Sex (% male) . | Individuals with LTBI and Lesions on CXR N/N with LTBI (%) . | Uninfected Controls With Lesions on CXR N/N Controls (%) . |
|---|---|---|---|---|---|---|---|---|---|---|
| Studies with control group | ||||||||||
| Bonfiglioli, 2014 [28] | Brazil (high) | Anti-TNF screening | Cohort | Signs of previous TB (fibrotic lesions)/TB sequelae. | TST ≥ 5 mm | 202 | 52 ± 11 | 16.8 | 6/44 (13.6) | 8/158 (5.1) |
| Christopoulos, 2009 [29] | Greece (low) | Screening HD/PD | Cohort | Dense pulmonary nodules, with or without visible calcification, in the hilar area or upper lobes, smaller nodules with or without fibrotic scars in the upper lobes, accompanied with upper lobe volume loss bronchiectasis of the upper lobe and/or pleural scarring. | TST ≥ 10 mm | 272 | 25–77 | 71.0 | 27/62 (43.5) | 40/210 (19.0) |
| Costantino, 2013 [30] | France (low) | Anti-TNF screening | Cross-sectional | Suggestive of previous TB infection (pulmonary nodules, upper lobe bronchiectasis, apical pleural thickening, interstitial granulomatous calcifications, cavitations, and lymph node or pericardial calcifications). | TST ≥ 5 mm T-SPOT+ TST ≥ 5 mm and T-SPOT+ | 196 122 279 | 51.0 NR NR | 53.1 44.3 38.4 | 14/196 (7.1) 13/122 (10.7) 9/59 (15.3) | NA NA 2/220 (0.9) |
| Foster, 2016 [31] | Canada (low) | Screening HD/PD | Cohort | Evidence of previous TB infection (including infiltrates, tissue loss, and cavitations upper lobe). | TST ≥ 5 mm TST ≥ 10 mm | 476 465 | 62 ± 11 62 ± 11 | 49.1 49.1 | 14/62 (22.6) 12/43 (27.9) | 107/406 (25.4) 89/422 (21.1) |
| Jeong, 2012 [32] | South Korea (high) | Routine CXR | Case control | Old, healed TB (calcified nodular densities, fibrosis/nodular densities, basal pleural thickening ≥10mm, and bronchiectasis upper lobe). | TST ≥ 10 mm QFT+ | 271 319 | 18–88 18–88 | NR 58.6 | 89/131 (67.9) 150/228 (65.8) | 74/140 (52.9) 43/91 (47.3) |
| Joshi, 2007 [33] | India (high) | Screening HCW | Cross-sectional | Suggestive of inactive TB (fibrotic scar [with volume loss], [non-] calcified nodules [with volume loss], bronchiectasis, pleural thickening, diaphragmatic tenting, and blunt costophrenic angle. | TST ≥ 10 mm QFT+ TST ≥ 10 mm and QFT+ | 276 328 209 | 32 ± 12 NR NR | NR NR NR | 174/276 (63.0) 163/261 (62.5) 131/209 (62.7) | NA 43/67 (64.2) NA |
| Katsenos, 2011 [34] | Greece (low) | Contact investigation | Cross-sectional | Abnormal findings (fibrotic-appearing apical lesions). | TST ≥ 5 mm | 77 | 75 | 15.6 | 0/26 (0) | 6/51 (11.8) |
| Kim, 2010 [35] | South Korea (high) | Pre-transplant screening | Cohort | Abnormal findings suggestive of inactive TB. | TST ≥ 5 mm TST ≥ 10 mm T-SPOT+ | 209 209 184 | NR NR NR | NR NR NR | 5/47 (10.6) 3/21 (14.3) 5/65 (7.7) | 5/162 (3.1) 7/188 (3.7) 4/119 (3.4) |
| Kleinert, 2012 [36] | Germany (low) | Anti-TNF screening | Cross-sectional | Lesions suggestive of latent or prior TB. | TST ≥ 5 mm QFT+ T-SPOT+ TST ≥ 5 mm and IGRA+ | 1529 685 844 1368 | NR NR NR NR | 38.7 NR NR 37.9 | 15/173 (8.7) 3/50 (6.0) 15/70 (21.4) 13/66 (19.7) | 12/1356 (0.9) 7/635 (1.1) 2/777 (0.3) 7/1302 (0.5) |
| Roelsgaard, 1961 [37] | Kenya (high) | Population study | Cross-sectional | Infiltrate with cavity, infiltrate without cavity, calcified or fibrotic lesions, and pleural adhesions. Where more than 1 shadow was seen, the classification into type of lesion was determined by the most “severe“ finding. | TST ≥ 10 mm | 4946 | NR | NR | 231/2475 (9.3) | 82/2471 (3.3) |
| Seyhan, 2009 [38] | Turkey (low) | Screening HD/PD | Cross-sectional | TB scar lesions (dense pulmonary nodules with/without calcification in hilar area or upper lobes, and pleural thickening). | TST ≥ 10 mm QFT+ | 100 100 | 56 ± 15 56 ± 15 | 47.0 47.0 | 4/34 (11.8) 11/43 (25.6) | 12/66 (18.2) 5/57 (8.8) |
| Sichletidis, 2006 [39] | Greece (low) | Anti-TNF screening | Cohort | An abnormal CXR suggesting latent TB (apical fibrotic lesions and pleural calcification). | TST ≥ 10 mm | 613 | 49 ± 8 | 32.1 | 5/45 (11.1) | 0/568 (0) |
| Tafuri, 2011 [40] | Italy (low) | Immigrant screening | Cross-sectional | TB sequelae. | TST+ | 669 | 25 | NR | 99/554 (17.9) | 16/115 (13.9) |
| Triverio, 2009 [41] | Switzerland (low) | Immigrant screening | Cohort | Suggestive of prior TB. | TST ≥ 5 mm | 62 | 65 ± 15 | 74.2 | 2/12 (16.7) | 6/50 (12.0) |
| QFT+ | 57 | NR | NR | 3/13 (23.1) | 5/44 (11.4) | |||||
| T-SPOT+ | 55 | NR | NR | 1/18 (5.6) | 5/37 (13.5) | |||||
| Vassilopoulos, 2009 [42] | Greece (low) | Anti-TNF screening | Cohort | Suggestive of previous, inactive TB (calcified or noncalcified nodules or fibrotic scars). | TST ≥ 5 mm | 155 | 52 ± 16 | 41.9 | 9/58 (15.5) | 5/97 (5.2) |
| QFT+ | 155 | 52 ± 16 | 41.9% | 4/32 (12.5) | 10/123 (8.1) | |||||
| T-SPOT+ | 155 | 52 ± 16 | 41.9 | 4/39 (10.3) | 10/116 (8.6) | |||||
| Wauters, 2004 [43] | Belgium (low) | Screening HD/PD | Cross-sectional | TB lesions: dense pulmonary nodules with or without visible calcification in the hilar area or upper lobes or pleural scarring were scored as positive findings. | TST ≥ 10 mm | 224 | 68 ± 13 | 58.0 | 22/73 (30.1) | 34/151 (22.5) |
| Studies without control group | ||||||||||
| Bailey, 1977 [18] | United States (low) | Routine CXR | Cohort | Consistent with old TB. | TST+ | 1524 | NR | NR | 61/1524 (4.0) | NA |
| Eisenberg, 2009 [19] | United States (low) | Pre-employment | Cross-sectional | Abnormalities suggestive of chronic TB infection (calcified granulomas and lymph nodes, apical pleural thickening, fibrosis, and nodules). | TST ≥ 10 mm | 875 | 18–65 | 44.8 | 91/875 (10.4) | NA |
| Eisenberg, 2010 [20] | United States (low) | Pre-employment | Cross-sectional | Evidence of prior TB infection included apical or basal pleural thickening; fibrous scarring; calcified granulomas and/or, calcified lymph nodes; and noncalcified nodules. | TST ≥ 10 mm TST ≥ 10 mm and QFT+ | 2586 | 18–65 | 45.0 | 159/2586 (6.1) 8/135 (5.9) | NA NA |
| Eisenberg, 2017 [21] | United States (low) | Routine CXR | Cohort | Evidence of prior TB infection (apical pleural thickening, fibrous scarring, calcified granulomas/lymph nodes and noncalcified nodules). | TST ≥ 10 mm | 2518 | 18–93 | 38.9 | 196/2518 (7.8) | NA |
| Gershon, 2004 [22] | Canada (low) | TB clinic | Cohort | Abnormal findings consistent with previous TB. | TST ≥ 10 mm or TST ≥ 5 mm | 308 | NR | 56.8 | 77/308 (25.0) | NA |
| Gottridge, 1989 [23] | Unites States (low) | Screening HCW | Cohort | Apical pleural thickening, active parenchymal lesion, cavitating lesion, pleural effusion, fibrocalcific disease, unrelated abnormality, or other abnormal CXR findings consistent with previous TB. | TST ≥ 10 mm | 221 | 18–65 | 33.9 | 9/221 (4.1) | NA |
| Kunimoto, 2009 [24] | Canada (low) | Routine CXR | Cross-sectional | Findings suggestive of previous TB (TB scar). | TST ≥ 5 mm TST ≥ 5 mm and QFT+ | 1446 566 | NR 32 ± 16c | 37.5 41.7 | 304/1446 (21.0) 170/566 (30.0) | NA NA |
| Manadan, 2007 [25] | United States (low) | Anti-TNF screening | Cohort | Evidence of old granulomatous disease. | TST ≥ 10 mm | 43 | NR | NR | 10/43 (23.2) | NA |
| Meyer, 2003 [26] | United States (low) | Routine CXR | Cross-sectional | Lesions suggestive of tuberculosis infection abnormal, fibrosis, granuloma, consolidation or cavity, pleural disease, and calcified lymph nodes. | TST+ | 535 | 39 ± 15 | 48 | 75/535 (14.0) | NA |
| Nolan, 1988 [27] | United States (low) | Immigrant screening | Cohort | Abnormal CXRs consistent with inactive TB. | TST ≥ 10 mm | 3300 | NR | NR | 185/3300 (5.6) | NA |
Abbreviations: CXR, chest radiography; HCW, healthcare workers; HD/PD, hemodialysis/peritoneal dialysis; IGRA, interferon gamma release assay; LTBI, latent tuberculosis infection; NA, not applicable; NR, not reported; QFT, QuantiFERON Gold in-tube; TB, tuberculosis; TNF, tumor necrosis factor; T-SPOT, T-SPOT.TB; TST, tuberculin skin test.
a TB-endemicity was considered high in case of ≥40 cases of active TB/100 000 inhabitants per year.
b Mean (± standard deviation, if available) or range; median used only if mean or range were not described.
c Median.
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