QuantiFERON TB gold testing for tuberculosis screening in an inflammatory bowel disease cohort in the United States
| Autor: | Michael H. Bonner, Bashar J. Qumseya, Lilani P. Perera, Sue Skaros, Amar S. Naik, Yelena Zadvornova, Mazen Issa, David G. Binion, Ashwin N. Ananthakrishnan |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Tuberculosis Concordance Inflammatory bowel disease QuantiFERON Cohort Studies Latent Tuberculosis Internal medicine medicine Immunology and Allergy Humans Mass Screening Mass screening Retrospective Studies business.industry Tuberculin Test Tumor Necrosis Factor-alpha Gastroenterology Retrospective cohort study Mycobacterium tuberculosis bacterial infections and mycoses medicine.disease Inflammatory Bowel Diseases United States Surgery Cohort Female business Cohort study |
| Zdroj: | Inflammatory bowel diseases. 17(1) |
| ISSN: | 1536-4844 |
| Popis: | Background: Reactivation of latent Mycobacterium tuberculosis (TB) is a rare, yet devastating infectious complication associated with anti-tumor necrosis factor alpha (TNF-α) therapy. We evaluated the performance of the QuantiFERON TB Gold test (QFT-G) for TB screening in a cohort of inflammatory bowel disease (IBD) patients in the United States. Methods: We performed a retrospective, observational study of patients initiated and/or maintained on an anti-TNF-α agent in a single IBD referral center and recorded the frequency and the test results of QFT-G testing and the rate of TB reactivation. Results: 512 QFT-G tests were done in 340 patients. Five patients (1.5%) had a positive, nine (2.7%) indeterminate, and 326 patients (95.8%) had a negative QFT-G. After a mean follow-up of 17 months there was one case of TB reactivation (0.3%). The use of immunosuppressive therapy or anti-TNF therapy at the time of testing did not affect the results of the QFT-G testing. Test–retest had substantial concordance (κ = 0.72). 25% of patients (n = 85) had TST testing. Concordance between the TST and QFT-G was found to be moderate (κ = 0.4152, P = 0.0041). Conclusions: Most patients with negative QFT-G tolerated anti-TNF therapy with no evidence of TB reactivation. Concomitant use of immunosuppressive therapy or anti-TNF did not seem to affect QFT-G results. One patient had an indeterminate QFT-G while on infliximab and later developed miliary TB. Concordance with TST is moderate. (Inflamm Bowel Dis 2011;) |
| Databáze: | OpenAIRE |
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