Executive summary of the guidelines for the use of interferon-γ release assays in the diagnosis of tuberculosis infection

Santín, Miguel; García-García, José-María; Rigau, David; Altet, Neus; Anibarro, Luis; Casas, Irma; Díez, Nuria; García-Gasalla, Mercedes; Martínez-Lacasa, Xavier; Penas, Antón; Pérez-Escolano, Elvira; Sánchez, Francisca; Domínguez, J.

doi:10.1016/j.eimc.2015.11.021

Cited by 14 publications

(13 citation statements)

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“…Taken together, here we describe how IMIDs can negatively affect the accuracy of IGRAs, being Crohn’s disease patients the most affected individuals due to their concomitant immunosuppressant drug-profile and impaired immune response. Therefore, in the absence of a gold standard, it seems prudent to diagnose LTBI using both the TST and IGRAs with the aim of detecting all possible cases in patients with IMIDs [ 24 , 25 ], giving special attention to those with a poor accuracy of IGRAs and/or TST such as Crohn’s disease. In addition, the use of TST in psoriasis has to be taken with caution.…”

Section: Discussionmentioning

confidence: 99%

Immune-mediated inflammatory diseases differently affect IGRAs’ accuracy for latent tuberculosis infection diagnosis in clinical practice

et al. 2017

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BackgroundClinical accuracy of IGRAs remains unclear on patients with immune-mediated inflammatory diseases (IMIDs). Here, we assess the impact of immunosuppressants and IMIDs on QuantiFERON-TB Gold In-Tube (QFN-G-IT) and T-SPOT.TB accuracy.MethodsPatients with IMIDs who required latent tuberculosis infection (LTBI) screening were enrolled and classified into: (i) 50 patients with inflammatory rheumatic diseases, (ii) 50 patients with psoriasis and (iii) 30 patients with Crohn’s disease. A total of 44 healthy individuals without immunosuppression were also included as controls. Tuberculin skin test (TST), T-SPOT.TB and QFN-G-IT assays were performed. IGRAs were performed following manufacturer’s instructions.ResultsImmunosuppressant’s intake was more frequent on patients with Crohn’s disease and psoriasis. Positive IGRAs and TST results were reduced in Crohn’s disease patients, whereas rate of indeterminate T-SPOT.TB results was increased in this group with respect to the other IMIDs analysed and controls. When IFN-γ response was studied, the levels of this cytokine after mitogen stimulation were significantly lower in Crohn’s and inflammatory rheumatic diseases than in psoriasis. Interestingly, psoriatic patients were the only ones not receiving corticosteroids. Furthermore, a negative correlation was observed between the IFN-γ secreted after mitogen stimulation and corticosteroids dose.ConclusionsIMIDs seem to negatively affect the clinical accuracy of IGRAs, being Crohn’s disease patients the most affected individuals due to their concomitant drug-profile and impaired immune response.

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Section: Discussionmentioning

confidence: 99%

Immune-mediated inflammatory diseases differently affect IGRAs’ accuracy for latent tuberculosis infection diagnosis in clinical practice

et al. 2017

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“…There is no single criterion that identifies contacts vaccinated with BCG as infected and, in practice, different cut-off points have been used [3,30], showing how difficult it is to determine the effect of BCG on the TST [30]. To detect this effect, interferon-gamma release assays should be used in these patients in order to detect false positives and avoid unnecessary treatment [31].…”

Section: Discussionmentioning

confidence: 99%

A highly transmissible tuberculosis outbreak: the importance of bars

et al. 2017

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The transmission of tuberculosis (TB) in bars is difficult to study. The objective was to describe a large TB outbreak in a company's bar and other leisure settings. A descriptive study of a TB outbreak was carried out. Contacts were studied in the index case's workplace bar (five circles of contacts) and other recreational areas (social network of three bars in the index case's neighbourhood). Chest X-rays were recommended to contacts with positive tuberculin skin tests (TST) (⩾5 mm). The risk of latent tuberculosis infection (LTBI) was determined using an adjusted odds ratio. The dose-response relationship was determined using the chi-square test for linear trend. We studied 316 contacts at the index case's workplace and detected five new cases of TB. The prevalence of LTBI was 57·9% (183/316) and was higher in the first circle, 96·0% (24/25), and lower in the fifth, 46·5% (20/43) (P < 0·0001). Among 58 contacts in the three neighbourhood bars, two TB cases were detected and the LTBI prevalence was 51·7% (30/58). Two children of one secondary TB company patient became ill. Bars may be transmission locations for TB and, as they are popular venues for social events, should be considered as potential areas of exposure.

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“…En éstos es una causa importante de morbilidad y mortalidad, así como en pacientes inmunosuprimidos. LTBI es el síndrome clínico causado por la exposición al M. tuberculosis seguida de infección, evidenciada por la presencia de prueba cutánea positiva de tuberculina (PPD) en ausencia de signos y síntomas clínicos y radiológicos de la enfermedad activa (3,4) . El diagnóstico de la LTBI requiere por ende los datos epidemiológicos, la historia personal o familiar, el examen físico y los estudios de laboratorio, ya que se estima que una cuarta parte de la población mundial tiene tuberculosis latente.…”

Section: Esta Enfermedad Transmisible Causada Por Organismos Del Compunclassified

Latent tuberculosis confirmed by in vitro release of interferon gamma

Delvalle

Domínguez

Díaz

et al. 2018

Rev. Nac. (Itauguá)

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105 mujeres. Provenían de la Seguridad Social 56 casos, Ministerio de Salud 35 y Servicios Públicos 176. Resultaron positivas 38 muestras (15%) y 10 indeterminados (4%). Los casos positivos fueron 18% mujeres, 37% del rango 81 a 90 años, provenían 16% de servicios privados, 24% tenían cuadro pulmonar, 20% tenían enfermedad autoinmune y contacto con bacilíferos, 15% cuadros mieloproliferativos, 6% eran trasplantados. Conclusiones: se confirmaron 38 (15%) LTBI en el país con el IGRA, mayoría adultos de 81 a 90 años y mujeres, 24% cuadros pulmonares, 20% contactos y autoinmunes. El 16% de servicios privados, que sugiere mayor vigilancia en esta población.

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Executive summary of the guidelines for the use of interferon-γ release assays in the diagnosis of tuberculosis infection

Cited by 14 publications

References 1 publication

Immune-mediated inflammatory diseases differently affect IGRAs’ accuracy for latent tuberculosis infection diagnosis in clinical practice

Immune-mediated inflammatory diseases differently affect IGRAs’ accuracy for latent tuberculosis infection diagnosis in clinical practice

A highly transmissible tuberculosis outbreak: the importance of bars

Latent tuberculosis confirmed by in vitro release of interferon gamma

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