Superiority of Interferon Gamma Assay Over Tuberculin Skin Test for Latent Tuberculosis in Inflammatory Bowel Disease Patients in Brazil

Amorim, Renata Fernandes de; Viegas, Eduardo R.; Carneiro, Antonio José V.; Esberard, Barbara C.; Chinem, Evelyn S; Correa, Raquel S; Rodrigues, Luciana Silva; Ribeiro-Alves, Marcelo; Silva, Kelly Samara da; Souza, Heitor Siffert Pereira de; Carvalho, Ana Teresa Pugas

doi:10.1007/s10620-019-5475-3

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…The studies were published between 2008 and 2021 and included enrollment periods ranging from 2006 to 2017 [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Among the 20 included studies, 14 were prospective cohort studies [ 22 , 23 , 25 , 26 , 28 , 29 , 30 , 32 , 33 , 35 , 37 , 38 , 40 , 41 ], 5 were retrospective cohort studies [ 24 , 27 , 31 , 34 , 39 ], and the remaining 1 was a retrospective case–control study [ 36 ]. Fifteen studies reported IGRA-positive or IGRA-indeterminate rates according to IST [ 22 , 23 , 26 , 27 , 28 , 29 , 30 , 32 , 34 , 36 , 37 , 38 , 39 , 40 , ...…”

Section: Resultsmentioning

confidence: 99%

“…Among the 20 included studies, 14 were prospective cohort studies [ 22 , 23 , 25 , 26 , 28 , 29 , 30 , 32 , 33 , 35 , 37 , 38 , 40 , 41 ], 5 were retrospective cohort studies [ 24 , 27 , 31 , 34 , 39 ], and the remaining 1 was a retrospective case–control study [ 36 ]. Fifteen studies reported IGRA-positive or IGRA-indeterminate rates according to IST [ 22 , 23 , 26 , 27 , 28 , 29 , 30 , 32 , 34 , 36 , 37 , 38 , 39 , 40 , 41 ]. Of these studies, 11 performed the IGRA using the QFT method [ 22 , 23 , 26 , 28 , 30 , 32 , 36 , 37 , 38 , 40 , 41 ] and 2 used the T-SPOT method [ 27 , 34 ], whereas 1 performed IGRA using both the QFT and T-SPOT [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies reported IGRA-positive or IGRA-indeterminate rates according to IST [ 22 , 23 , 26 , 27 , 28 , 29 , 30 , 32 , 34 , 36 , 37 , 38 , 39 , 40 , 41 ]. Of these studies, 11 performed the IGRA using the QFT method [ 22 , 23 , 26 , 28 , 30 , 32 , 36 , 37 , 38 , 40 , 41 ] and 2 used the T-SPOT method [ 27 , 34 ], whereas 1 performed IGRA using both the QFT and T-SPOT [ 29 ]. The remaining study did not provide information about the type of IGRA method [ 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…The remaining study did not provide information about the type of IGRA method [ 39 ]. Additionally, 11 studies reported TST-positive rates according to the IST [ 22 , 23 , 26 , 28 , 29 , 32 , 35 , 37 , 38 , 40 , 41 ]. Among them, 7 used different cutoff values according to the risk of TB to determine a TST-positive result [ 22 , 23 , 26 , 32 , 37 , 38 , 41 ], whereas the other 4 used 5 mm as a cutoff value regardless of TB risk [ 28 , 29 , 35 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

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Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Park

Jung

2022

JPM

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Screening for latent tuberculosis infection (LTBI) is mandatory before commencing tumor necrosis factor (TNF)-α inhibitor use. However, the impact of immunosuppressive therapy (IST), including corticosteroids and immunomodulators, on the performance of LTBI screening in patients with inflammatory bowel disease (IBD) has not been fully elucidated. We searched all relevant studies published before November 2021 that examined the performance of interferon γ release assays (IGRAs) and tuberculin skin tests (TSTs) in patients with IBD who received IST, using the Medline, EMBASE, and Cochrane Library databases. We performed meta-analyses of positive or indeterminate rates of IGRA or TST according to IST and calculated the concordance rates between IGRA and TST results. A total of 20 studies with 4045 patients were included in the meta-analysis. The IGRA-positive rate was lower in patients on IST than in those not on IST (odds ratio (OR) (95% confidence interval (CI)) = 0.55 (0.39–0.78)), whereas the IGRA-indeterminate rate was higher in patients on IST than in those not on IST (OR (95% CI) = 2.91 (1.36–6.24)). The TST-positive rate did not differ between the on-IST and not-on-IST groups (OR (95% CI) = 0.87 (0.51–1.50)). The concordance rate between IGRA and TST was 83.3% (95% CI, 78.5–88.1%). The IGRA-negative/TST-positive rate tended to be higher than that the IGRA-positive/TST-negative rate (9.5% vs. 5.8%, respectively), although the difference was not statistically significant. In conclusion, IGRA results were negatively affected by IST in patients with IBD, supporting requirements that IGRA should be performed before initiating IST. The use of both an IGRA and TST in patients with IBD on IST may improve the diagnosis rate of LTBI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Park

Jung

2022

JPM

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“…The two main immunodiagnostic methods currently used for the diagnosis of LTBI are the tuberculin skin test (TST) [6] and the interferon gamma (IFN-γ) release assays (IGRAs) [7]. These tests work on the principle of in vivo and ex vivo cell-mediated immunity, respectively [8].…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Mycobacterium Tuberculosis-Specific Antigens and T-Cell Mitogen-Stimulated Interferon Gamma Production in Hemodialysis Patients and Healthy Individuals

Park

Kim

Park

et al. 2020

Preprint

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Abstract Background: The incidence of Tuberculosis (TB) is higher in patients undergoing chronic hemodialysis than in the general population; further, both the incidence and development of active TB from latent TB infection (LTBI) are considerably higher in patients undergoing hemodialysis than in any other group. The QuantiFERON-TB Gold In-Tube (QFT-GIT) assay is one of the most commonly used interferon gamma (IFN-γ) release assays (IGRAs) currently. We aim to know T-cell function of hemodialysis patients and the possible QFT false negatives.Methods: In order to analyze the MTB-specific antigen-stimulated IFN-γ release in patients on hemodialysis, the QFT-GIT test was used in this study. A total of 84 hemodialysis patients and 52 healthy subjects were enrolled from Kosin University Gospel Hospital and Catholic University of Pusan, Busan, Republic of Korea; their whole blood samples were collected and used for the present study.Results: The positivity results of the IGRAs in hemodialysis patients and normal subjects were 34/84 (40.4%) and 4/52 (7.6%), respectively. The median value of MTB-specific antigen-stimulated IFN-γ in hemodialysis patients with LTBI and non-LTBI status in hemodialysis patients, healthy individuals were 1.85 IU/mL (4.44ng/mL) and 0.028 IU/mL (0.067 ng/mL) and 0.255 IU/mL (0.612 ng/mL) respectively. In addition, Of the 34 LTBI status in hemodialysis patients, 14 (41.2%) had T-cell mitogen-stimulated IFN-γ levels of 10 or less, and 20 (58.8%) had 10 or more T-cell mitogen-stimulated IFN-γ. Moreover, Of the 49 non-LTBI status in hemodialysis patients, 19 (38.8%) and 30 (61.2%) respectively. On the other hand, there was no low level of T-cell mitogen-stimulated IFN-γ in the healthy individuals.Conclusion: This reveals that T-cell function in hemodialysis patients was reduced as compared to the healthy individuals. Therefore, the cut-off value should be adjusted for the active TB high-risk group when using IGRA tests. The clinical manifestations of TB in patients on hemodialysis are quite non-specific, making timely diagnosis difficult, and delaying the initiation of curative treatment, delay being a major determinant of outcome.

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Screening for latent tuberculosis before starting TNF-alpha inhibitors in a population with high BCG vaccination rates

et al. 2021

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Superiority of Interferon Gamma Assay Over Tuberculin Skin Test for Latent Tuberculosis in Inflammatory Bowel Disease Patients in Brazil

Cited by 12 publications

References 33 publications

Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Comparative Analysis of Mycobacterium Tuberculosis-Specific Antigens and T-Cell Mitogen-Stimulated Interferon Gamma Production in Hemodialysis Patients and Healthy Individuals

Screening for latent tuberculosis before starting TNF-alpha inhibitors in a population with high BCG vaccination rates

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