» Articles » PMID: 31523944

[Concordance Between the Test of the Tuberculin and Interferon Gamma Release Assay-IGRA in Patients with Immune-mediated Inflammatory Diseases]

Overview
Specialty Pharmacology
Date 2019 Sep 17
PMID 31523944
Citations 2
Authors
Affiliations
Soon will be listed here.
Abstract

Objective: The immunosuppressive therapies in the treatment of the immune-mediated inflammatory diseases (EIMI) predispose individuals to the tuberculosis, so the screening of latent tuberculosis infection (ITL) and the treatment reduces the likelihood of a progression to an active tuberculosis. The aim of the study was to analyze the concordance between the test of the tuberculin (PT) and "Interferon Gamma Release Assay-IGRA" in relation to the type of EIMI and the immunosuppressive treatment (IS).

Methods: Transversal study of patients with EIMI candidates or in treatment IS forwarded to the ITL screening, from April 2017 until May 2018. The outcome variables were PT and IGRA. The explicative variables were: EIMI, IS, age, gender, prior BCG vaccination and tuberculosis risk factors.

Results: A total of 146 patients were analyzed (33[22.6%] vaccinated with BCG, 1 [0.7%] with a pre-diagnosis of tuberculosis, and 22 [15.1%] from an endemic country). Kappa index (k) was 0,338 between PT and IGRA for the whole sample. A lower concordance was found in patients with the Crohn's disease (k=0.125), in the ones treated with corticosteroids (k=0.222), vaccinated with BCG (k=0.122) and in patients from tuberculosis endemic countries (k=0.128).

Conclusions: The concordance between PT and IGRA is affected in patients with EIMI, and to a greater extent to patients with the inflammatory bowel disease, with the corticotherapy, with the BCG vaccination, or in the ones from endemic countries.

Citing Articles

Assessing the Diagnostic Performance of New Commercial Interferon-γ Release Assays for Mycobacterium tuberculosis Infection: A Systematic Review and Meta-Analysis.

Ortiz-Brizuela E, Apriani L, Mukherjee T, Lachapelle-Chisholm S, Miedy M, Lan Z Clin Infect Dis. 2023; 76(11):1989-1999.

PMID: 36688489 PMC: 10249994. DOI: 10.1093/cid/ciad030.


Diagnosis for Latent Tuberculosis Infection: New Alternatives.

Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, Torres M Front Immunol. 2020; 11:2006.

PMID: 33013856 PMC: 7511583. DOI: 10.3389/fimmu.2020.02006.

References
1.
Munoz L, Casas S, Juanola X, Bordas X, Martinez C, Santin M . Prevention of anti-tumor necrosis factor-associated tuberculosis: a 10-year longitudinal cohort study. Clin Infect Dis. 2014; 60(3):349-56. DOI: 10.1093/cid/ciu796. View

2.
Sellam J, Hamdi H, Roy C, Baron G, Lemann M, Puechal X . Comparison of in vitro-specific blood tests with tuberculin skin test for diagnosis of latent tuberculosis before anti-TNF therapy. Ann Rheum Dis. 2007; 66(12):1610-5. PMC: 2095326. DOI: 10.1136/ard.2007.069799. View

3.
Inanc N, Aydin S, Karakurt S, Atagunduz P, Yavuz S, Direskeneli H . Agreement between Quantiferon-TB gold test and tuberculin skin test in the identification of latent tuberculosis infection in patients with rheumatoid arthritis and ankylosing spondylitis. J Rheumatol. 2009; 36(12):2675-81. DOI: 10.3899/jrheum.090268. View

4.
Schoepfer A, Flogerzi B, Fallegger S, Schaffer T, Mueller S, Nicod L . Comparison of interferon-gamma release assay versus tuberculin skin test for tuberculosis screening in inflammatory bowel disease. Am J Gastroenterol. 2008; 103(11):2799-806. DOI: 10.1111/j.1572-0241.2008.02050.x. View

5.
Maeda T, Banno S, Maeda S, Naniwa T, Hayami Y, Watanabe M . Comparison of QuantiFERON-TB Gold and the tuberculin skin test for detecting previous tuberculosis infection evaluated by chest CT findings in Japanese rheumatoid arthritis patients. J Infect Chemother. 2011; 17(6):842-8. DOI: 10.1007/s10156-011-0250-1. View