Comparison of Interferon-Gamma Release Assay<i>Versus</i>Tuberculin Skin Test for Tuberculosis Screening in Inflammatory Bowel Disease

Schoepfer, Alain; Flogerzi, Beatrice; Fallegger, S; Schaffer, Thomas; Mueller, Stefan O.; Nicod, Laurent P.; Seibold, Frank

doi:10.1111/j.1572-0241.2008.02050.x

Cited by 107 publications

(88 citation statements)

References 39 publications

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“…The sensitivity and specificity of IGRA in older children exposed to index cases are similar compared to adults, as long as they are not infected by HIV; although a few studies have shown a lower sensitivity for IGRA tests in very young children (25,53,54). The lower sensitivity found for both TST and IGRAs among very young children might be explained by immune immaturity or having a population with underlying conditions that may interfere with immunity, such as co-infections with helminthes and malnutrition; although BCG is not expected to interfere with IGRAs (55).…”

Section: B) Childrenmentioning

confidence: 98%

New Advances in Diagnosis of Latent Tuberculosis Infection: A Review Article

Mardani

Abtahian

2014

Arch Pediatr Infect Dis

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Context: It has been estimated that one-third of the world's population are suffering from latent tuberculosis infection (LTBI). In order to control tuberculosis in high-risk groups proper diagnosis and treatment is essential. Evidence Acquisition: Useless and expensive tests such as unfocused population-based tests can lead to futile and unnecessary treatments. Targeted screening approaches and individualization of LTBI treatment protocols must be a priority. Results: Diagnostic methods with immune based tests such as the tuberculin skin test (TST) or interferon gamma release assays (IGRA) can accurately detect LTBI. However, interferon-gamma release assays have higher specificity than TST in Bacille Camette-Gurin (BCG)-vaccinated populations; both tests are precise to identify latent tuberculosis. However, it is of great concern that both tests have insignificant roles in predicting risk of progression to active tuberculosis. Conclusions: Here we review the clinical applications, advantages, and limitations of the tuberculin skin test and interferon-gamma release assays and provide an overview of the most recent systematic reviews conducted for the comparison of these tests.

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Section: B) Childrenmentioning

confidence: 98%

New Advances in Diagnosis of Latent Tuberculosis Infection: A Review Article

Mardani

Abtahian

2014

Arch Pediatr Infect Dis

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“…A study conducted in Brazil, where tuberculosis is endemic, showed that the PPD was not very effective in detecting LTB in patients with rheumatic diseases before undergoing biological therapy [6]. In recent years, new methods for detecting tuberculosis based on quantification of gamma-interferon after stimulation with specific antigens, known as IGRA (Interferon-Gamma Release Assay), have shown better results than PPD, including in immunosuppressed patients [7]. However, in a recent publication, Wong SH et al demonstrated that IBD patients on immunosuppressive therapy had a significantly lower IGRA positive rate (13.0% versus 29.6%; P = 0.002) compared to immunosuppressant-naive IBD patients.…”

Section: Discussionmentioning

confidence: 99%

Mediastinal Tuberculosis Lymphadenitis during Anti-TNF Therapy - Case Report

Silva¹,

Nascimento²,

Lisboa³

et al. 2015

Arch Clin Gastroenterol

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Tuberculosis is described during the use of monoclonal antibodies against tumour necrosis factor (TNF) for Crohn's disease treatment. We report a case of a 44 year old man that developed fever, night sweats and weight loss during immunosuppressive and anti-TNF therapy for Crohn's disease. After extensive investigation we performed mediastinoscopy with biopsy of the paratracheal lymph node. A histopathological study revealed caseous necrosis. The patient improved after therapy against tuberculosis. During anti-TNF therapy, the diagnosis of tuberculosis may be mainly difficult when an atypical location is present. Clinical skills are important mainly in countries where tuberculosis is endemic.

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“…However, in subjects vaccinated with BCG, the specificity of QFT-G was 96% (95%CI: 94%-98%) while that of TST was only 59% (95%CI: 46%-73%). A Swiss study has compared TST and QFT-G performances in IBD patients [17] . The studied population comprised 114 patients with Crohn's disease (CD), 44 with ulcerative colitis (UC), 10 with indeterminate colitis and 44 control subjects.…”

Section: Mycobacterium Tuberculosismentioning

confidence: 99%

What is the best way to manage screening for infections and vaccination of inflammatory bowel disease patients?

Andrisani

Armuzzi

Marzo

et al. 2016

WJGPT

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increased risk of opportunistic infections, in particular of viral or bacterial etiology. Despite the existence of international guidelines, many gastroenterologists have not adopted routine screening and vaccination in those patients with IBD, which are candidate for biologic therapy. Available strategies to screen, diagnose and prevent bacterial and viral infections in patients with IBD prior to start biological therapy are discussed in this review. Core tip: The increasing use of biologics as a mainstay of therapy in inflammatory bowel disease (IBD) is associated with an increased risk for a variety of infections, many of which are preventable by prior screening and vaccination. While immunocompetent IBD patients can be vaccinated using standard vaccination schedule, special guidelines need to be followed for IBD patients getting immunosuppressive therapy (IST). This article provides a review of the issues surrounding immunizations in the IBD patient and a practical guide for clinicians regarding the appropriate screening for infections and vaccinations to administer both before and during IST. AbstractThe use of biological agents and immunomodulators for inflammatory bowel disease (IBD) is associated with an REVIEWSubmit a

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Comparison of Interferon-Gamma Release AssayVersusTuberculin Skin Test for Tuberculosis Screening in Inflammatory Bowel Disease

Abstract: Agreement between the two test methods is poor in IBD patients. In contrast to the QFT-G-IT test, the TST is negatively influenced by immunosuppressive medication and vaccination status, and should thus be replaced by the IGRA for TB screening in immunosuppressed patients having IBD.

Cited by 107 publications

References 39 publications

New Advances in Diagnosis of Latent Tuberculosis Infection: A Review Article

New Advances in Diagnosis of Latent Tuberculosis Infection: A Review Article

Mediastinal Tuberculosis Lymphadenitis during Anti-TNF Therapy - Case Report

What is the best way to manage screening for infections and vaccination of inflammatory bowel disease patients?

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