Poor concordance between interferon-γ release assays and tuberculin skin tests in diagnosis of latent tuberculosis infection among HIV-infected individuals

Talati, Naasha J; Seybold, Ulrich; Humphrey, Bianca J.; Aina, Abiola; Tapia, Jane; Weinfurter, Paul; Albalak, Rachel; Blumberg, Henry M.

doi:10.1186/1471-2334-9-15

Cited by 95 publications

(93 citation statements)

References 20 publications

(31 reference statements)

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“…However, TST reactivity to BCG has also been demonstrated long after the period that the effect of the BCG vaccination is expected to have waned off 20 , which may explain why our study found more LTBI among adolescents who had a BCG scar (BCG vaccination). Though the demonstration of TST reactivity to BCG vaccination creates controversy about the use of TST to measure LTBI in countries with high BCG coverage, such as Uganda 21,22 , studies that used interferon gamma release assays (IGRA's), that are believed not to be affected by BCG have shown no added value in estimation of LTBI in high BCG vaccination areas 7,8,22 .…”

Section: Risk Factors Of Latent Tb Infectionmentioning

confidence: 99%

Prevalence and risk factors of latent Tuberculosis among adolescents in rural Eastern Uganda

Mumpe-Mwanja

Verver²,

Yeka

et al. 2015

Afr H. Sci.

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Background: Latent Tuberculosis treatment is a key tuberculosis control intervention. Adolescents are a high risk group that is not routinely treated in low income countries. Knowledge of latent Tuberculosis (TB) burden among adolescents may influence policy. Objectives: We determined the prevalence and risk factors of latent TB infection among adolescents in rural Uganda. Methods: We analyzed baseline data from a study that assessed the prevalence and incidence of Tuberculosis disease among adolescents. We extracted socio-demographics, medical assessment information, and tuberculin skin test results and estimated prevalence ratios (PR) of latent TB infection risk factors by binomial regression. Results: The prevalence of latent TB was 16.1%, 95% CI (15.1 -17.2). Significant risk factors were: a BCG scar, APR 1.29 (95% CI 1.12 -1.48); male gender, APR 1.37 (95% CI 1.21 -1.56); age 17 -18 years, APR 1.46 (95% CI 1.24 -1.71) and 15-16 years, APR 1.25 (95% CI 1.07 -1.46) compared to 12-14 years; being out of school, APR 1.31 (95% CI 1.05 -1.62); and a known history of household TB contact in last 2 years, APR 1.91 (95% CI 1.55 -2.35) Conclusion: Targeted routine latent TB treatment among adolescents out of school may be crucial for TB disease control in low income countries.

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Section: Risk Factors Of Latent Tb Infectionmentioning

confidence: 99%

Prevalence and risk factors of latent Tuberculosis among adolescents in rural Eastern Uganda

Mumpe-Mwanja

Verver²,

Yeka

et al. 2015

Afr H. Sci.

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“…Yine HIV pozitif hastalarda IGRA ve TCT'nin karşılaştırıldığı çalışmalarda pozitiflik oranında bir fark saptanmamıştır [27][28][29][30] .…”

Section: Discussionunclassified

Anti-Tümör Nekroz Faktör Alfa Tedavisi ve Tüberkülin Cilt Testi

Bozkırlı¹,

Tufan²,

Özışık³

et al. 2015

Cukurova Medical Journal

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Purpose: The use of anti-tumor necrosis factor alpha (anti-TNF) drugs has been a milestone in the treatment of rheumatic diseases. Despite their strong efficacy, there are some factors restricting the use of anti-TNF agents. We must be careful especially for the granulomatous diseases which can be seen endemic in our country such as tuberculosis and leishmaniasis. In our country according to the RAED 2005 Consensus Meeting Reports, patients candidate for anti-TNF treatment are evaluated for both active and inactive tuberculosis before treatment and prophylaxis with isoniazid (INH) has been performed where indicated. Material and Methods: Tuberculin skin tests (TST) of 43 patients followed up in the Rheumatology Clinic and receiving anti-TNF therapy were repeated under treatment. Patients' pretreatment first TST results, drugs they used, INH prophylaxis state, smoking status and the duration of anti-TNF treatment were evaluated. Results: 14 patients (32.6%) were women, while 29 (67.4%) were men. The mean of first TST values were 11.72±90.3 mm (0-30) and the mean of second TST values were 12.06±12.4 mm (0-45). 48.8% of the patients were smoking and 74.4% of the patients had received INH prophylaxis for 9 months. The mean total duration of anti-TNF drug use was found as 22.67±19.11 (5-68) months. No statistically significant difference (p=0.888) was observed between the first pretreatment and second under treatment TST results of the patients. Discussion: Tuberculosis remains to be a serious public health problem for both our country and the whole world. For this reason in our country, a detailed assessment is performed for all patients before anti-TNF treatment. In our study patients who are planned to start anti-TNF therapy were assessed with their first TST values and INH prophylaxis were given to 32 patients (74.4%) before treatment. No statistically significant difference was observed between pre and posttreatment TST values when control TST were performed with the earliest after five months of treatment. These findings may suggest that there is no evident increase in the risk of tuberculosis for patients receiving anti-TNF treatment with appropriate INH prophylaxis.

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“…39 However some studies have shown that IGRAs (particularly the TBSPOT.TB assay) might be more sensitive than the TST in detecting latent TB infection in people who are HIV infected with severe immune suppression. [40][41][42][43][44][45][46][47] A study in South Africa demonstrated that patients with very low CD4 counts who had recently been treated for active TB had high rates of response using the TSPOT.TB test. This study suggested that the TSPOT.TB has utility even in a population that had a mean CD4 + T-cell count of 98.…”

Section: Discussionmentioning

confidence: 99%

Recent Advances in Testing for Latent TB

Schluger

Burzynski

2010

Chest

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Exposure to a person with infectious TB can result in one of three outcomes: the innate immune system can clear the infection immediately, leaving no evidence of exposure to TB; Mycobacterium tuberculosis organisms can begin to proliferate immediately, causing so-called primary TB; or the growth of organisms can be controlled or contained but not stopped by the host patient's immune response, setting up a state of latent infection. In this state, viable organisms are contained intracellularly within macrophages and within granulomas. 1 People with latent TB are at risk for active TB disease. Lifetime risk of active TB in patients with latent infection, as detected by means of a tuberculin skin test (TST), is estimated to be in the 5% to 10% range, with roughly one-half of that risk occurring in the fi rst year or two after latent infection develops. In addition, the risk of development of reactivation is greater in people with medical conditions associated with immunosuppression, such as infection with HIV or treatment with drugs such as corticosteroids or tumor necrosis factor antagonists. 2 In the United States, treatment of latent infection is a key component of the overall public health plan for controlling TB. 3 Cases of active TB in the United States have fallen steadily since 1992, and the overall rate of TB in this country now stands at 4.3/100,000, the lowest prevalence that has been recorded here. 4 The sharp decline in TB in the United States over the last several years has largely come about because of efforts aimed at diagnosing and treating patients with active disease, thereby reducing transmission and secondary cases. However, if TB is to be eliminated in this country (a stated goal of the US Public Health Service), there is no question that efforts in treating latent TB must be strengthened. 5 A recent study estimates that there is a reservoir of at least 20 million people in this country with latent TB infection, and without treatment, a large number of them will progress to active disease. 6 Furthermore, the majority of cases of active TB in this country now occur in people born outside the United States, and treating latent infection in recent immigrants from high-prevalence countries is the only way to prevent cases of active disease from developing.For the past several years, the US Centers for Disease Control and Prevention (CDC) has emphasized After more than a century of relying on skin testing for the diagnosis of latent TB infection, clinicians now have access to blood-based diagnostics in the form of interferon g release assays (IGRAs). These tests are generally associated with higher sensitivity and specifi city for diagnosis of latent TB infection. This article reviews the indications for testing and treatment of latent TB infection in the overall context of a TB control program and describes how IGRAs might be used in specifi c clinical settings and populations, including people having close contact with an active case of TB, the foreign born, and health-care workers.CHEST 2010; 13...

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Poor concordance between interferon-γ release assays and tuberculin skin tests in diagnosis of latent tuberculosis infection among HIV-infected individuals

Cited by 95 publications

References 20 publications

Prevalence and risk factors of latent Tuberculosis among adolescents in rural Eastern Uganda

Prevalence and risk factors of latent Tuberculosis among adolescents in rural Eastern Uganda

Anti-Tümör Nekroz Faktör Alfa Tedavisi ve Tüberkülin Cilt Testi

Recent Advances in Testing for Latent TB

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