Journals / Turkish Journal of Gastroenterology / 2018 / Cilt: 29 - Sayı: 3

Screening for latent tuberculosis infection in patients with inflammatory bowel disease: Can interferon-gamma release assays replace the tuberculin skin test?

Pages
292–298
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Overall, 71% patients were receiving immunosuppressants.

📌 3 Key Takeaways

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Objective & Hypothesis:Background/Aims: Screening for latent tuberculosis infection is mandatory before starting anti-tumor necrosis factor therapy.
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Key Findings & Data:New assays based on interferon-γ (IFN-γ) release have recently become available and may be more accurate.
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Conclusion & Impact:Overall, 71% patients were receiving immunosuppressants.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Background/Aims: Screening for latent tuberculosis infection is mandatory before starting anti-tumor necrosis factor therapy. New assays based on interferon-γ (IFN-γ) release have recently become available and may be more accurate. The aim of this study was to compare QuantiFERON-TB and tuberculin skin test in screening for latent infection in patients with inflammatory bowel disease. Materials and Methods: We prospectively screened 138 patients with inflammatory bowel disease for latent tuberculosis infection with chest X-ray, tuberculin skin test, and a third-generation QuantiFERON-TB test. The association of the results in both tests with immu-nosuppression or inflammatory activity was determined by logistic regression.Results: The tuberculin skin test and QuantiFERON-TB were positive in 21.7% and 24.6% of the patients, respectively. Overall, 71% patients were receiving immunosuppressants. Concordance between the two tests was moderate (κ=0.59; 95% confidence interval (CI), 0.43-0.75) and was higher in immunosuppressant-naïve patients (κ=0.75; 95% CI, 0.52-0.97) than in immunosuppressed patients (κ=0.51; 95% CI, 0.30-0.72). In both the tests, disease activity and receiving immunosuppression were not associated with the test re-sults. Nevertheless, QuantiFERON-TB was negatively influenced with two or more immunosuppressive drugs.Conclusion: Concordance between the two tests was moderate, and it appears lower with immunosuppression. QuantiFERON-TB alone may be appropriate in immunosuppressant-naïve patients. Both tests should be considered in immunosuppressed patients.

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Cite This Article

CABRIADA, J. L., RUIZ-ZORRILLA, R., BARRIO, J., ATIENZA, R., HUERTA, A., RODRIGUEZ-LAGO, I., BERNAL, A., HERRERO, C. (2018). Screening for latent tuberculosis infection in patients with inflammatory bowel disease: Can interferon-gamma release assays replace the tuberculin skin test?. Turkish Journal of Gastroenterology, Cilt: 29 - Sayı: 3, 292–298. https://ajindex.com/articles/410155

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