How does a TB (tuberculosis) test work?
Both types of TB tests — the skin test and blood test — work by measuring your immune system’s response to antigens taken from the bacterium that causes TB: Mycobacterium tuberculosis. An antigen is any substance that causes your immune system to produce antibodies against it. This means your immune system doesn’t recognize the substance and is trying to fight it off.
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How a TB skin test works
A TB skin test measures your immune system’s response to a purified protein derivative (PPD) solution injected under your skin. PPD is a protein that comes from the bacteria that causes TB — Mycobacterium tuberculosis.
It’s not live bacteria, and it won’t make you sick. If you’ve ever been exposed to the TB bacteria, your skin will react to the antigens by developing a firm, red bump at the site of the injection within three days.
How a TB blood test works
In most cases, if you’ve been infected with TB, blood cells from your blood sample will release a protein called interferon-gamma (IFN- γ) when mixed with antigens derived from Mycobacterium tuberculosis in a laboratory.
To conduct the tests, laboratory scientists mix your blood sample with antigens and controls and measure the reaction using a method called immunoassay. They’ll interpret your results as negative, positive or indeterminate.
What do I need to do to prepare for a TB test?
You don't need to do anything special to prepare for a TB skin test or blood test.
What should I expect during a TB (tuberculosis) test?
The TB (tuberculosis) testing process is different based on what kind you get — the skin test or the blood test.
TB skin test process
A TB skin test requires two or three visits with a healthcare provider. During the first visit, they inject fluid into your arm. On the second visit, the healthcare provider assesses your skin’s reaction to the injection. If still negative, the third visit (72 hours) is needed.
During the first visit:
- A healthcare provider will clean and disinfect the skin on your lower inner arm.
- They’ll inject a small amount of fluid (called tuberculin or PPD) with a tiny needle under the skin on your lower inner arm.
- The provider may mark the injection site by circling the area with a pen. This makes it easier for them to find the area when assessing the reaction.
- A small bump will form where they injected the fluid. It should go away in a few hours.
You’ll then return to your provider within 48 to 72 hours so that they can look for a reaction on your arm where they injected the fluid. Firm swelling and redness at the site may indicate a TB infection. It’s important to go to your second appointment to get an official result. If you don’t return within 72 hours, you’ll need to take the test again. Immunocompromised individuals and those with frail skin conditions may not have reliable skin test results.
TB blood test process
You can expect to experience the following during a blood test, or blood draw:
- You’ll sit in a chair, and a healthcare provider will check your arms for an easily accessible vein. This is usually in the inner part of your arm on the other side of your elbow.
- Once they’ve located a vein, they’ll clean and disinfect the area.
- They’ll then insert a small needle into your vein to take a blood sample. This may feel like a small pinch.
- After they insert the needle, a small amount of blood will collect in a test tube.
- Once they have enough blood to test, they’ll remove the needle and hold a cotton ball or gauze on the site to stop the bleeding.
- They’ll place a bandage over the site, and you’ll be finished.
The entire procedure usually takes less than five minutes.
After a healthcare provider has collected your blood sample, they’ll send it to a laboratory for testing. Once the test results are back, your healthcare provider will share the results with you.
Does a TB test hurt?
For both a TB skin test and blood test, you may feel a small pinch from the needle, but this will be brief. For a skin TB test, the liquid the healthcare provider injects should not burn or feel uncomfortable.
What are the risks of a TB (tuberculosis) test?
There are very few risks to having a TB skin test or blood test.
For a TB skin test, you may feel a pinch when you get the injection. For a TB blood test, you may have slight tenderness or a bruise at the site of the blood draw, but this usually resolves quickly.
