Diagnosis of tuberculosis infection using interferon-γ-based assays

Cerezales, Miguel Santín; Benítez, José Domínguez

doi:10.1016/s0213-005x(11)70015-5

Cited by 25 publications

(14 citation statements)

References 93 publications

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“…TB seemed to be more useful than TST for diagnosing active TB. The result consists with previous findings (Menzies et al, 2007;Pai et al, 2008;Thijsen et al, 2009;Santín Cerezales et al, 2011).…”

Section: Discussionsupporting

confidence: 77%

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

Qin¹,

Wang²,

Wang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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The diagnosis of latent Mycobacterium tuberculosis infection (LTBI) is recommended in hematological malignancy patients and before hematopoietic stem cell transplantation (Guidelines for the prevention and management of infectious complications of solid organ transplantation, 2004). Compared to traditional methods such as tuberculin skin test (TST), T-SPOT.TB has been shown to be more specific. In the present study we enrolled 536 patients for whom T-SPOT.TB was performed, among which 295 patients also received the TST test. The agreement (79%) between T-SPOT.TB and TST was poor (κ=0.274, P<0.001). The patients with positive T-SPOT.TB results numbered 62 (11.6%), in which only 20 (48.8%) of the 41 receiving the TST test had positive results. A majority of the patients with T-SPOT.TB positive results had some other evidence ofTB, such as TB history, clinical symptoms and an abnormal chest CT scan. Active TB was found in 9 patients, in which 2 had negative TST results. We followed up the patients and no one developed active TB. Our study suggested that the T-SPOT.TB may be more useful for screening LTBI and active TB in hematological malignancy patients and hematopoietic stem cell transplant recipients than the TST test.

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Section: Discussionsupporting

confidence: 77%

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

Qin¹,

Wang²,

Wang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…This assay has a high specificity in diagnosing TB infection via its use of Mycobacterium tuberculosis specific antigens, which are absent in the BCG strain. It is not affected by BCG vaccination or contact with non-TB mycobacteria species, seeming to have a better specificity and sensitivity than TST [15]. There are two types of IGRAs, the ELISA-Quantiferon and ELISpot; both appear to have similar efficacy [16].…”

Section: Discussionmentioning

confidence: 99%

“…However, IGRA should be performed in endemic areas and in those at higher risk of latent disease, such as already immunocompromised patients. IGRA might be more appropriate as a TB screening test in countries using routine BCG vaccination, like Portugal [15]. More recently, some consensus statements have advocated using both the TST and an IGRA to screen for TB latent infection in patients with chronic inflammatory disease before starting anti-TNFα therapy [12, 18, 19].…”

Section: Discussionmentioning

confidence: 99%

Miliary Tuberculosis in a Crohn’s Disease Patient: The Risk beyond the Screening

Carvalho

Túlio

Rodrigues

et al. 2018

GE Port J Gastroenterol

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Tumor necrosis factor alpha (TNFα) antagonist is recognized as an effective treatment to achieve clinical remission and healing mucosal in patients with moderate to severe active Crohn’s disease. Considering that it plays a central role in immune-mediated modulation, there are some obvious concerns about its long-term safety. There is evidence that it may increase the risk of opportunistic infections such as tuberculosis, particularly reactivation of previous latent infection. Due to the global high incidence of tuberculosis and its frequent severity in immunocompromised patients, the exclusion of latent infection is currently part of the screening prior to anti-TNFα therapy. Only a few cases of life-threatening disseminated tuberculosis have been reported in immunocompromised patients probably related to widespread use of higher-accuracy screening tests, such as interferon-γ release assays. However, despite negative screening, the risk of active tuberculosis infection remains during treatment. In that instance, tuberculosis infection becomes considerably more difficult to diagnose due to its altered pattern presentation (extrapulmonary and disseminated infection) and is harder to treat because of the high rate of resistance and its associated relevant morbidity and mortality. We report an enigmatic case of a miliary tuberculosis despite negative latent infection screening, using interferon-γ release assays, in a Crohn’s disease patient undergoing treatment with infliximab and azathioprine, focusing on the screening and diagnostic and therapeutic challenge. This case enhances the awareness of anti-TNFα therapy management and the need for strategies to diagnose and treat tuberculosis in this context.

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“…Although INF-γ release assays are affected by cellular immune statutes and age, they demonstrate low agreement with the TST and perform better in detecting latent TB in adult patients (Santín Cerezales 2011;Zhao et al, 2011). Both of the INF-γ release assays (T-SPOT.TB and QFT) require only a single patient visit, and the test results are available within 24 hours (Hill et al, 2004;Richeldi et al, 2004).…”

Section: Interferon-gamma Release Assays and Screening For Latent Tbmentioning

confidence: 99%

Diagnosis of Mycobacterium tuberculosis

Al-Zamel¹

2012

Understanding Tuberculosis - Global Experiences and Innovative Approaches to the Diagnosis

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Diagnosis of tuberculosis infection using interferon-γ-based assays

Cited by 25 publications

References 93 publications

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

Miliary Tuberculosis in a Crohn’s Disease Patient: The Risk beyond the Screening

Diagnosis of Mycobacterium tuberculosis

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