Latent and active tuberculosis infection in allogeneic hematopoietic stem cell transplant recipients: a prospective cohort study.

Autor: de Oliveira Rodrigues M; Universidade Paulista UNIP - Instituto de Ciências da Saúde, Bauru, Brazil., de Almeida Testa LH; HSCT Program - Amaral Carvalho Foundation, Jaú, Brazil., Dos Santos ACF; HSCT Program - Amaral Carvalho Foundation, Jaú, Brazil., Zanetti LP; HSCT Program - Amaral Carvalho Foundation, Jaú, Brazil., da Silva Ruiz L; Centro de Laboratórios Regionais, Instituto Adolfo Lutz - Bauru II, São Bauru, Brazil., de Souza MP; HSCT Program - Amaral Carvalho Foundation, Jaú, Brazil., Colturato VR; HSCT Program - Amaral Carvalho Foundation, Jaú, Brazil., Machado CM; HSCT Program - Amaral Carvalho Foundation, Jaú, Brazil. clarimm@usp.br.; Institute of Tropical Medicine, University of São Paulo School of Medicine (LIM 52 HC-FMUSP), São Paulo, Brazil. clarimm@usp.br.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2021 Sep; Vol. 56 (9), pp. 2241-2247. Date of Electronic Publication: 2021 May 08.
DOI: 10.1038/s41409-021-01329-3
Abstrakt: Tuberculosis (TB) is a major infectious complication in hematopoietic stem cell transplant (HSCT) recipients in countries with high TB prevalence. Identifying and treating latent tuberculosis infection (LTBI) helps to prevent TB reactivation after transplantation. Few studies have compared the tuberculin skin test (TST) with interferon Gamma release assays (IGRA) to diagnose LTBI in HSCT candidates. We compared TST and QuantiFeron TB gold in tube (QTF-GIT) and prospectively evaluated the incidence of active tuberculosis in 126 HSCT candidates and 58 HSCT recipients with chronic GVHD followed at the outpatient clinic. TB was diagnosed by culture in Mycobacteria media and by commercial real-time PCR kit. Considering the positivity of any test, the prevalence of LTBI was 8.7% in HSCT candidates (11 out of 126) and 12.5% in HSCT recipients with chronic GVHD (6 out of 48). QTF-GIT indeterminate results were detected in 2.4% of the HSCT candidates. Fair to good agreement (K > 0.50) between tests was observed in both cohorts. Cumulative incidence of TB was 3% in the GVHD cohort. TB was diagnosed in 2 chronic GVHD recipients, both cases confirmed by positive culture and PCR. None of the 11 patients with LTBI diagnosed pre-HSCT who received INH prophylaxis developed TB.
(© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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