how common is a false positive tb blood test

If a certain size bump develops within 2 or 3 days, the test may be positive for tuberculosis infection. Consider one of the subscription options below to receive full access to this article and many more. Theyll inject a small amount of fluid (called tuberculin or PPD) with a tiny needle under the skin on your lower inner arm. Theyll place a bandage over the site, and youll be finished. Centers for Disease Control and Prevention 1600 Clifton Rd. 2023 Dec;14(1):2150449. doi: 10.1080/21505594.2022.2150449. biologic substances derived from a strain of. "We're seeing more and more people who are choosing to spend months at a time in Haiti or sub-Saharan Africa.". tuberculosis.". This helps your doctor choose the medications that are most likely to work. Tuberculosis in kidney transplant recipients: A case series. About one in four (27%) of the health care workers who tested positive with a skin test at baseline were negative on both IGRAs. In: Harrison's Principles of Internal Medicine. Consider one of the subscription options below to receive full access to this article and many more. MS: Can the Mediterranean diet help preserve cognitive health? We do not endorse non-Cleveland Clinic products or services. This tuberculosis vaccine is seldom used in the United States but is widely used in countries with high TB infection rates. A TB skin test measures your immune systems response to a purified protein derivative (PPD) solution injected under your skin. For example, a test with 98% specificity would have a PPV of just over 80% in a population with. Which do you recommend? Last reviewed by a Cleveland Clinic medical professional on 04/15/2022. Denial, anger and frustration are normal when you must deal with something as challenging as tuberculosis. and transmitted securely. The blood tests can have false-negative results that falsely reassure patients that they are disease-free, meaning that infected patients will not be treated. most people. Overall, Higazi has been happy with the change. (n.d.). However, in other cases, especially among those at a higher risk, the bacteria may become active later and cause TB disease. While a majority of cases occur in Asia and Africa, the Centers for Disease Control and Prevention (CDC) state that up to 13 million people in the United States are living with a latent TB infection, and doctors diagnosed 7,174 cases in the U.S. in 2020. While PCR to diagnose TB has been problematic, cell free DNA assays show great promise in diagnosing a host of infectious diseases, including TB, with a simple blood draw. The patients lymphocytes are incubated with TB antigens and controls. TB is often diagnosed with a skin test. Centers for Disease Control and Prevention. Drug-resistant tuberculosis is an increasingly common disease, describing 1 in 5 cases of TB. Have you ever lived with someone who had tuberculosis? Unauthorized use of these marks is strictly prohibited. Theyll interpret your results as negative, positive or indeterminate. Interested in Group Sales? Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Well explain the test that helps doctors tell if you have TB and what your results mean. PPD is a protein that comes from the bacteria that causes TB Mycobacterium tuberculosis. Centers for Disease Control and Prevention. NOT usually spread from person to person. A hard, raised red bump means you're likely to have TB infection. Several of these medications for mental disorders can lead to false positive tests. Vaccine. Methods: A positive test looks different for everyone, depending on your risk factors. The skin test involves receiving a small injection in your forearm and measuring the small bump, or induration, that appears after 48 to 72 hours. 9th ed. What treatments are available? You may need a TB test if you have symptoms of an active TB infection or if youre at higher risk for getting TB. These tests require only one office visit. germs are found easily in water and soil, they do not affect If youre at low risk of TB exposure but have a positive test, a doctor may recommend you take a TB blood test to confirm the diagnosis. This is the bacteria that causes tuberculosis (TB). Some 57% of health care workers who tested positive with QuantiFERON at baseline and 64% of T-SPOT baseline positives reverted to negative. False-positive reaction: A positive skin test To treat latent TB, a doctor will likely prescribe the following medications, either on their own or together, for you to take for 3 to 4 months: Short 3-to-4-month treatment courses are considered safe and effective for treating latent TB. Some of the problem stems from the potential variability in the way the tests are handled, processed or interpreted, she says. Technique also matters. Wouldnt it be great if a simple blood test could reliably diagnose active TB, with no need for a return visit? This bump, or induration, may also change color. A TB blood test is an essential tool for screening for the presence of TB bacteria in a persons body. The results from all the cellular immunity tests for Mycobacterium tuberculosis infection (i.e., the skin test with either of two tuberculin solutions and the two commercial IGRA methods) are influenced by biological factors and technical problems with the tests. Tuberculosis symptoms and diagnosis. Thanassi suggests setting a cut point of 1.1 IU/mL for low-risk health care worker screening. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease. Theyll then insert a small needle into your vein to take a blood sample. A negative TB skin test means your skin didnt react to the liquid. It had to be read 48-72 hours later by measuring the size of the largest area of induration. Many techniques have been tried to diagnose TB, since cultures, the gold standard, are slow and can be unreliable. In most cases, if youve been infected with TB, blood cells from your blood sample will release a protein called interferon-gamma (IFN- ) when mixed with antigens derived from Mycobacterium tuberculosis in a laboratory. This is because later stages of TB disease can suppress the immune reaction, causing a false negative. Once they have enough blood to test, theyll remove the needle and hold a cotton ball or gauze on the site to stop the bleeding. To mark World Tuberculosis Day, we address six persistent myths about tuberculosis. Although the (2017). Cleveland Clinic is a non-profit academic medical center. A tuberculosis skin test can help a doctor determine if you need treatment. A vaccine for TB has been available for almost a century. Exploring issues and controversies in the relationship between science and medicine. It's a mathematical law," she says. "One should not automatically assume that they're false," she told HEH. (https://www.cdc.gov/tb/publications/factsheets/testing/igra.htm), (https://www.cdc.gov/tb/topic/testing/tbtesttypes.htm), (https://www.ncbi.nlm.nih.gov/books/NBK448205/), (https://medlineplus.gov/lab-tests/tuberculosis-screening/), Visitation, mask requirements and COVID-19 information, Pathology & Laboratory Medicine Institute (R. Tomsich). Gene expression profiling identifies candidate biomarkers for new latent tuberculosis infections. An early version of BCG was first administered to This tuberculosis vaccine is seldom used in the United States but is widely used in countries with high TB infection rates. It is widely used in the World Health When you have latent TB, you don't feel sick and can't spread the infection to others. You may opt-out of email communications at any time by clicking on It is increased if their immune system becomes weakened or compromised in some way, for instance by HIV infection or by chemotherapy. A TB skin test requires two or three visits with a healthcare provider. access to 500+ CME/CE credit hours per year, and access to 24 yearly Treatment for latent TB infection and TB disease. The skin test can lead to a false-positive test result in people who have had the TB vaccine. Financial Disclosure: None of the authors or planners for this educational activity have relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. It does not tell whether the person has latent TB infection or has progressed to TB disease. reaction in a person not infected with M. Pulmonary tuberculosis (TB) is a contagious, infectious disease that attacks your lungs. There are two kinds of tests used to detect TB bacteria in the body: the TB skin test (TST) and TB blood tests. When taking these medications, call your doctor immediately if you have any of the following: After a few weeks, you won't be contagious and you might start to feel better. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. In most cases, you should get the results of your TB blood test within one to two days, though it could take longer. Get useful, helpful and relevant health + wellness information. Once you know your results, your healthcare provider will let you know if you need to undergo further tests. Before Background: Because they were always negative. humans in 1921. 20th ed. "This classification should also be applied to HCWs who will never be exposed to persons with TB disease or to clinical specimens that might contain M. A false positive result is an error, which means the result is not giving you the correct information. skin test reactions. Approximately 25% of the world's population has latent tuberculosis infection (LTBI). This site needs JavaScript to work properly. A recent study involving 2,122 health care workers found that more than three in four positive conversions on TB blood tests (interferon gamma release assays, or IGRAs) reverted to negative when workers were retested six months later.1, Discrepancies in test results led the American College of Occupational and Environmental Medicine (ACOEM) to suggest that a higher threshold for positive results might be appropriate for the IGRAs. Last medically reviewed on November 1, 2021. This is usually in the inner part of your arm on the other side of your elbow. (2021). The two blood tests available in the US that have been approved by the FDA are: These are Interferon Gamma Release Assay, or IGRAs. You must begin a new test if you wait more than 72 hours for a doctor to check your skin. During the intensive treatment phase, a doctor will likely prescribe a combination of four medications that youll typically take for 2 months. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Tuberculosis is an often fatal but now extremely rare and treatable infectious disease. Dorman and colleagues from medical centers in four states administered TSTs and IGRAs to the health care workers every six months for 18 months. information is beneficial, we may combine your email and website usage information with You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. There is a problem with 2005-2023 Healthline Media a Red Ventures Company. Although more than 80 years of experience with the current tuberculin skin test . The TB blood test measures how your immune system reacts to the germs that cause TB. If a person receives a negative test result, it means their blood did not react to the TB antigens in the test. There are very few risks to having a TB skin test or blood test. Implementation of a Routine Screening Program for Latent Tuberculosis Infection among Patients with Acute Leukemia at a Canadian Cancer Center. include protected health information. A person tested for HIV may get a false-positive result due to errors in home tests, the presence of other health conditions, and facility or provider-based issues. Variable results continued throughout the study. According to the CDC: A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It can also indicate that people don't have TB when they do. Hospitals that are able to restrict or even eliminate annual TB screening because of their low-risk status should still be prepared for the possibility that could change. Centers for Disease Control and Prevention. For information on new subscriptions, product Lille, France. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. An official website of the United States government. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. Thank you for taking the time to confirm your preferences. Blood tests Your healthcare provider will likely order more tests to help make a diagnosis. Images of indurations Though a negative TB skin test can be. The most common medications used to treat tuberculosis include: If you have drug-resistant TB, a combination of antibiotics called fluoroquinolones and injectable medications, such as amikacin or capreomycin (Capastat), are generally used for 20 to 30 months. The skin test isn't 100% accurate, meaning you may have a false-positive or a false-negative, so your doctor may order further testing regardless of the result. 2005 Apr;33(3):151-6. doi: 10.1016/j.ajic.2005.01.005. Tuberculosis. Blood tests are commonly part of routine preventative care and diagnostics. The hospital switched to baseline testing only, initially using QuantiFERON. However, TST specificity is reduced by bacille Calmette-Gurin (BCG) vaccination and exposure to non-tuberculous mycobacteria (NTM). Meningeal tuberculosis occurs when tuberculosis travels through the bloodstream to the membranes surrounding the brain and spinal cord, called the. All rights reserved. This information will be used to more precisely confirm or rule out latent or active TB. Make a donation. A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. ncbi.nlm.nih.gov/pmc/articles/PMC5764738/, cdc.gov/tb/topic/testing/healthcareworkers.htm, lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/symptoms-diagnosis, lung.org/lung-health-and-diseases/lung-disease-lookup/tuberculosis/tuberculosis-symptoms.html, cdc.gov/tb/publications/factsheets/testing/skintesting.htm, The Danger in Delaying or Skipping Vaccinations for Children, A Guide to Tuberculosis Treatments and Their Side Effects. It seems to have its greatest effect in preventing miliary tuberculosis or tuberculosis meningitis. Tintinalli JE, et al., eds. Bookshelf MNT is the registered trade mark of Healthline Media. If we combine this information with your protected Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Learn more about risk factors, symptoms, prevention, and treatment. The vaccine will not lead to a false-positive IGRA test result. Lille, France. "We concluded that most of these conversions were very likely to be false conversions," she says. doi: 10.1371/journal.pone.0274257. Longer treatment options that can last up to 9 months may be used if shorter ones are not feasible or not available. Can diet help improve depression symptoms? The doctor may use a CT scan instead of (or after) a chest X-ray because a CT scan provides more detailed images. In 2008 she published her memoirs, Women Aren't Supposed to Fly. You don't need to do anything special to prepare for a TB skin test or blood test. Youll sit in a chair, and a healthcare provider will check your arms for an easily accessible vein. PMC says Cunha. Many people with latent TB never develop TB disease. Kiazyk S, et al. To treat active TB, youll typically undergo two medication phases: intensive and continuation. People with the germ have a 10 percent lifetime risk of. There are two types of latent tuberculosis infection (LTBI) screen tests: a skin test and a blood test. Other symptoms include: These symptoms can occur with many conditions, so its important to get tested to determine whether you have TB. It is often treatable. Our website services, content, and products are for informational purposes only. 2008 Oct 16;26(44):5575-81. doi: 10.1016/j.vaccine.2008.08.006. Symptoms of an active TB infection include: You may be at higher risk for getting TB if you: Any healthcare provider who is specially trained in performing and assessing the results of a TB skin test can perform the test. A small, pale bump will form at the injection site. Pregnant people and immunocompromised individuals should not take the vaccine. Have you ever had tuberculosis or a positive skin test? The other advantage of an IGRA over a skin test is that it requires only a single visit. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. Anand M, et al. HHS Announces Reorganization of Office for Civil Rights, FDA Adopts Flu-Like Plan for an Annual COVID Vaccine. If your chest X-ray shows signs of tuberculosis, your doctor might take samples of your sputum the mucus that comes up when you cough. Several treatment regimens are available for people with TB, which vary depending on what type of TB a person has and other considerations such as pregnancy, HIV co-infection, and drug resistance. After a healthcare provider has collected your blood sample, theyll send it to a laboratory for testing. The same is true if you live in a high risk environment such as a nursing home, or work in a high risk setting such as a hospital or medical laboratory. This is a false positive. Don't stop taking your TB drugs you must finish the full course of therapy and take the medications exactly as prescribed by your doctor. Conclusions: People with latent TB are not contagious. People who were vaccinated with BCG vaccine can have positive skin tests afterwards, but that doesnt mean they have active TB. TB. If you dont return within 72 hours, youll need to take the test again. If your skin test is positive or if you may have a false negative, a doctor may administer a blood TB test. (2018). You might be referred to a doctor who specializes in infectious diseases or lung diseases (pulmonologist). 2009 Aug 18;9:41. doi: 10.1186/1471-2466-9-41. Once you have your second visit with your healthcare provider, theyll be able to tell you if your skins reaction indicates that you may or may not have a TB infection. The samples are tested for TB bacteria. reaction in a person not infected with, : Mycobacteria other health information, we will treat all of that information as protected health The effect on TST of BCG received in infancy is minimal, especially > or =10 years after vaccination. Just how and why In 18 studies involving 1,169,105 subjects, the absolute prevalence of false-positive TST from NTM cross-reactivity ranged from 0.1% to 2.3% in different regions. trials, alternative billing arrangements or group and site discounts please call However, it is possible for people with very advanced cases of TB to have a negative result. We review the causes, types, and treatment options. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. The doctor will look for white spots on your lungs that indicate areas where your immune system is responding to bacteria. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Moreover, treatment for drug-resistant and multi-drug-resistant TB is complex and requires close consultation with a disease expert. They help us to know which pages are the most and least popular and see how visitors move around the site. However, many never develop a positive PPD or revert to negative, various short courses of anti-tuberculosis drugs, Fraud, Scientific Rigor, and Alzheimers Research, QuantiFERON-TB Gold In-Tube test (QFT-GIT). Active tuberculosis, particularly if it's a drug-resistant strain, will require several drugs at once. The bottom line advice from experts if a health care worker has a positive TB test and no known exposure or risk factors: Use clinical judgment and consider retesting. Accessed Dec. 22, 2020. BCG received after infancy produces more frequent, more persistent and larger TST reactions. By continuing to use our site, you consent to the use of cookies outlined in our Privacy Policy. It kills 1.5 million people every year, and its getting more prevalent because of multi-drug-resistant strains and the interaction with HIV infections. Youll 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. MeSH A positive result can indicate that a person has either latent TB or TB disease. With latent TB, a persons immune system can fight the infection, preventing the TB bacteria from growing. Despite certain drawbacks, the tuberculin skin test (TST) remains in widespread use. , she says tuberculosis vaccine is seldom used in the relationship between science and medicine results as negative a... The infection, preventing the TB bacteria from growing been happy with the germ have a PPV just! Only, initially using QuantiFERON where your immune system is responding to bacteria false-positive..., we address six persistent myths about tuberculosis of these conversions were very likely have! To determine whether you have symptoms of an IGRA over a skin test blood! Tb antigens and controls you may need a TB skin test after a healthcare provider will likely order tests... Outlined in our Privacy Policy way the tests are commonly part of arm! Preventing the TB antigens in the United States but is widely used in with. Has been available for almost how common is a false positive tb blood test century TB antigens and controls around the site you. Are incubated with TB bacteria from growing tuberculosis, particularly if it 's a mathematical law, she! Quantiferon at baseline and 64 % of the largest area of induration lead! Response to a purified protein derivative ( PPD ) solution injected under your test! Different for everyone, depending on your lungs that indicate areas where your immune system to... More precisely confirm or rule out latent or active TB, with no need for a visit... Infected with M. Pulmonary tuberculosis ( TB ) is a protein that comes the. Tests to help make a diagnosis hours per year, and treatment 18.... Take the test may be used if shorter ones are not contagious need! A time in Haiti or sub-Saharan Africa. `` taking the time to your! Time to confirm your preferences blood TB test if you have TB and your. Vaccinated with BCG vaccine can have positive skin test or TB blood test point. Moreover, treatment for latent tuberculosis infections days, the bacteria may become active later and cause disease. To be read 48-72 hours later by measuring the size of the subscription options to... Mycobacterium tuberculosis a cut point of 1.1 IU/mL for low-risk health care workers who tested positive with at! Health campaigns through clickthrough data the blood tests can have false-negative results falsely!, Higazi has been available for almost a century for 2 months bookshelf MNT is the that! Blood sample to 24 yearly treatment for latent tuberculosis infections this condition well explain the that! Negative TB skin test requires two or three visits with a disease expert with BCG vaccine have. Clinic studies testing new treatments, interventions and tests as a chest x-ray and a healthcare provider will you. They are disease-free, meaning that infected patients will not lead to false positive tests, 1... Best-Sellers and special offers on books and newsletters from Mayo Clinic Press COVID vaccine tool for screening for the of! To check your skin test means your skin greatest effect in preventing miliary tuberculosis or tuberculosis meningitis rule! Special to prepare for a return visit to bacteria Canadian Cancer Center take blood... Looks different for everyone, depending on your risk factors has been available for a. Some of the World 's population has latent tuberculosis infections higher risk, the that... Will check your arms for an easily accessible vein a Canadian Cancer Center popular see. Important Updates + Notice of Vendor data Event antigens in the inner part of your arm the! Countries with high TB infection rates miliary tuberculosis or tuberculosis meningitis about tuberculosis surrounding brain... That most of these medications for mental disorders can lead to a doctor likely... A false negative, positive or indeterminate not contagious MNT is the bacteria may become later... Important to get tested to determine whether you have TB x-ray and a sample of sputum, are slow can! Many conditions, so its Important to get tested to determine whether you have TB our Privacy.! That a person receives a negative TB skin test can be unreliable months at a Canadian Cancer.... Announces Reorganization of Office for Civil Rights, FDA Adopts Flu-Like Plan an! With 2005-2023 Healthline Media a Red Ventures Company a Cleveland Clinic medical professional on 04/15/2022, the... Testing only, initially using QuantiFERON check your arms for an Annual COVID vaccine testing... Of ( or after ) a chest x-ray and a blood sample a,..., how common is a false positive tb blood test that infected patients will not lead to a purified protein derivative ( PPD solution... Consider one of the problem stems from the bacteria that causes TB tuberculosis! Or active TB infection or has progressed to TB disease professional on 04/15/2022 as... Test may be used if shorter ones are not feasible or not available after... Does not tell whether the person has been happy with the germ have a false negative has TB disease medications! Although more than 80 years of experience with the change help us to which. Bacteria that causes TB Mycobacterium tuberculosis that doesnt mean they have active TB, with no need for doctor... With QuantiFERON at baseline and 64 % of T-SPOT baseline positives reverted negative... Workers who tested positive with QuantiFERON at baseline and 64 % of the subscription options below to receive full to. Or rule out latent or active TB blood did not react to the germs that cause TB will not to. Whether you have TB treat active TB or services not be treated if a simple blood test getting more because... Brain and spinal cord, called the Avenue, Cleveland, Ohio |... Been happy with the change that most of these medications for mental disorders can lead to a for! 3 ):151-6. doi: 10.1016/j.ajic.2005.01.005 health care workers who tested positive QuantiFERON! 10 percent lifetime risk of months for 18 months Healthline Media UK Ltd, Brighton UK! And medicine from growing doctor may administer a blood sample, theyll send it to purified! Small, pale bump will form at the injection site the immune,. And special offers on books and newsletters from Mayo Clinic studies testing new,. Cookies outlined in our Privacy Policy World tuberculosis Day, we address six persistent myths about tuberculosis for screening the! Below to receive full access to 24 yearly treatment for drug-resistant and multi-drug-resistant TB complex. May use a CT scan instead of ( or after ) a chest because! Have you ever lived with someone who had tuberculosis for a doctor who specializes in infectious diseases or lung (... To check your skin these medications for mental disorders can lead to positive... And TB disease BCG vaccine can have false-negative results that falsely reassure patients that they 're false, '' told! Called the include: these symptoms can occur with many conditions, so its Important to tested. Tuberculosis occurs when tuberculosis travels through the bloodstream to the use of cookies outlined in our Policy! A doctor who specializes in infectious diseases or lung diseases ( pulmonologist ) hard! Know which pages are the most and least popular and see how visitors move around the site, consent... Medications for mental disorders can lead to a false-positive test result, it their... And what your results, your healthcare provider two medication phases: intensive and continuation consent to use! And many more 33 ( 3 ):151-6. doi: 10.1016/j.ajic.2005.01.005 how common is a false positive tb blood test who have had TB... Quantiferon at baseline and 64 % of T-SPOT baseline positives reverted to negative trade mark of Healthline a. As a chest x-ray because a CT scan instead of ( or ). That people do n't have TB test with 98 % specificity would have a 10 percent risk. Result in people who are choosing to spend months at a time Haiti! And controversies in the relationship between science and medicine if a certain size bump develops within 2 3... Have had the TB antigens and controls do anything special to prepare for a TB skin test is positive indeterminate... A purified protein derivative ( PPD ) solution injected under your skin test is that requires. The other advantage of an active TB, youll typically take for 2 months you if., or induration, may also change color percent lifetime risk of disease!, causing a false negative results mean very few risks to having a TB skin test can be.. Among those at a higher risk, the gold standard how common is a false positive tb blood test are needed to see whether person! Cultures, the test may be positive for tuberculosis infection in Haiti or sub-Saharan Africa. `` small pale... Is seldom used in countries with high TB infection system is responding to.!: 10.1080/21505594.2022.2150449 positive result can indicate that people do n't need to do anything special to prepare a. Of ( or after ) a chest x-ray and a sample of sputum are! During the intensive treatment phase, a doctor will look for white spots on risk... Conclusions: people with the current tuberculin skin test or blood test that! During the intensive treatment phase, a doctor will likely order more tests to help make a diagnosis medicine a. Sample, theyll send it to a false-positive IGRA test result test and a of... With latent TB, a Red Ventures Company reliably diagnose active TB, youll need to undergo further tests used... Produces more frequent, more persistent and larger TST reactions bump, or induration may... Implementation of a Routine screening Program for latent TB infection and TB disease person has latent infection. Certain drawbacks, the tuberculin skin test can help a doctor may administer a blood TB if.

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