Monitoring frequency of interferon gamma release assay for tuberculosis surveillance following infliximab therapy in patients withCrohn'sdisease

Autor:	Qin-Yu Yang, Lin Zhang, Cheng-Dang Wang, Yi-Juan Liu, Xu Ye
Rok vydání:	2021
Předmět:	History of tuberculosis medicine.medical_specialty Crohn's disease Tuberculosis Latent tuberculosis biology Tuberculin Test business.industry Gastroenterology Interferon gamma release assay medicine.disease biology.organism_classification Inflammatory bowel disease Infliximab Mycobacterium tuberculosis Interferon-gamma Crohn Disease Internal medicine medicine Humans business Retrospective Studies medicine.drug
Zdroj:	Journal of Digestive Diseases. 22:473-480
ISSN:	1751-2980 1751-2972
DOI:	10.1111/1751-2980.13032
Popis:	OBJECTIVE To characterize the pattern of positive conversion of interferon gamma release assay (IGRA) in patients with Crohn's disease (CD) during infliximab therapy in China, which has a high burden of tuberculosis. METHODS Eligible patients with CD who received serial IGRA screening during infliximab therapy from January 2015 to March 2020 were retrospectively included. The positive conversion rate of IGRA and the risk of subsequent tuberculosis of the patients were analyzed. RESULTS A total of 128 patients with CD were included, and the median time from the initiation of IFX treatment to positive conversion or the last follow-up test of IGRA was 43.6 weeks. At baseline 3.9% of the patients were positive for IGRA and received prophylactic anti-tuberculosis treatment. In the other 123 patients with negative IGRA at baseline, 6.5% had IGRA positive conversion during infliximab treatment, and one (12.5%) who was exposed to Mycobacterium tuberculosis was diagnosed as having active tuberculosis. The conversion rate at 40 weeks, 2 years and 3 years after treatment were 10.0% (6/60), 2.2% (1/46) and 5.9% (1/17), respectively. Age, sex, history of smoking and alcohol consumption, disease severity (Crohn's disease activity index score) and immunosuppressive therapy were not significantly associated with latent tuberculosis test conversion. CONCLUSIONS Positive conversion of IGRA occurs early during treatment with infliximab for CD and the monitoring frequency of IGRA should be appropriately increased at the early stage of treatment. Physicians should pay attention to patient's history of tuberculosis exposure and carry out surveillance in a timely fashion.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::028cb840552bcddaeeffe7f37311d3c4 https://doi.org/10.1111/1751-2980.13032 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.