Role of Quantiferon TB Test in Identifying Patients at Risk For Reactivation of Tuberculosis in Liver Transplant Recipients in an Endemic Setting.

Anand, Raktima; Addala, Pavan Kumar; Vibhute, Bipin; Murugan, N.; Gopasetty, Mahesh; Varma, Mukund; Gopalakrishnan, Ram; Khakhar, Anand

doi:10.1097/00007890-201407151-00505

Cited by 1 publication

(1 citation statement)

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“…Our analysis included a total of 7811 participants, including 1361 with positive Characteristics of included studies are shown in Table 1. Ten studies were conducted in kidney transplantation, [15][16][17][18][19][20][21][22][23][24][25] nine in liver transplantation, [26][27][28][29][30][31][32][33][34] one in lung transplantation, 35 and four in mixed populations of solid organ transplantation. [36][37][38][39] Twelve studies compared the odds of a positive IGRAs and TST in candidates/recipients with or without risk factors, whereas nine studies compared TST alone and three studies compared IGRAs alone.…”

Section: Studies Identifiedmentioning

confidence: 99%

Tests for latent tuberculosis in candidates for solid organ transplantation: A systematic review and meta‐analysis

Myint

Rogerson

Noble

et al. 2019

Clinical Transplantation

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Reactivation of latent tuberculosis following solid organ transplantation has serious consequences for the recipient. The most useful diagnostic test for latent TB is not clear. We conducted a systematic review and meta-analysis to assess the relative test performance of interferon gamma release assays (IGRAs) and the tuberculin skin test (TST) in people undergoing solid organ transplantation. The clinical or radiological risk factors were used as the proxy reference standard. Test performance was expressed as an odd ratio (OR). We identified 24 studies (N = 7811), 12 studies compared IGRAs with TST directly, nine studies evaluated only TST and three studies only IGRAs. Direct comparison between tests and clinical risk factors indicated both tests were strongly associated with the presence of clinical risk factors for TB (TST: OR 3.17; 95%CI 1.55-6.48, IGRA: OR 2.78; 95%CI 1.55-5.01), and radiological evidence of past TB (TST: OR 3.26; 95%CI 1.85-5.73, IGRA: OR 3.85; 95%CI 2.16-6.86). Relative comparison indicated IGRAs positivity was more strongly associated with presence of radiological evidence of TB than TST (relative OR: 3.24; 95%CI 1.10-9.56). While there is no strong evidence in supporting use of IGRAs over TST for diagnosing latent TB, IGRAs positivity is more associated with the presence of radiological evidence of previous TB. K E Y W O R D S interferon gamma release assay, latent tuberculosis, solid organ transplantation, testing, tuberculin skin test S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Maung Myint T, Rogerson TE, Noble K, Craig JC, Webster AC. Tests for latent tuberculosis in candidates for solid organ transplantation: A systematic review and meta-analysis. Clin Transplant. 2019;33:e13643.

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