Screening for latent tuberculosis infection in patients with inflammatory bowel disease: Can interferon-gamma release assays replace the tuberculin skin test?

Cabriada, José Luis; Ruiz-Zorrilla, Rafael; Barrio, Jesús; Atienza, R.; Huerta, Alaín; Rodríguez‐Lago, Iago; Bernal, Antonio; Herrero, César

doi:10.5152/tjg.2018.17162

Cited by 5 publications

(8 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The studies were published between 2008 and 2021 and included enrollment periods ranging from 2006 to 2017 [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Among the 20 included studies, 14 were prospective cohort studies [ 22 , 23 , 25 , 26 , 28 , 29 , 30 , 32 , 33 , 35 , 37 , 38 , 40 , 41 ], 5 were retrospective cohort studies [ 24 , 27 , 31 , 34 , 39 ], and the remaining 1 was a retrospective case–control study [ 36 ]. Fifteen studies reported IGRA-positive or IGRA-indeterminate rates according to IST [ 22 , 23 , 26 , 27 , 28 , 29 , 30 , 32 , 34 , 36 , 37 , 38 , 39 , 40 , ...…”

Section: Resultsmentioning

confidence: 99%

“…Among the 20 included studies, 14 were prospective cohort studies [ 22 , 23 , 25 , 26 , 28 , 29 , 30 , 32 , 33 , 35 , 37 , 38 , 40 , 41 ], 5 were retrospective cohort studies [ 24 , 27 , 31 , 34 , 39 ], and the remaining 1 was a retrospective case–control study [ 36 ]. Fifteen studies reported IGRA-positive or IGRA-indeterminate rates according to IST [ 22 , 23 , 26 , 27 , 28 , 29 , 30 , 32 , 34 , 36 , 37 , 38 , 39 , 40 , 41 ]. Of these studies, 11 performed the IGRA using the QFT method [ 22 , 23 , 26 , 28 , 30 , 32 , 36 , 37 , 38 , 40 , 41 ] and 2 used the T-SPOT method [ 27 , 34 ], whereas 1 performed IGRA using both the QFT and T-SPOT [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies reported IGRA-positive or IGRA-indeterminate rates according to IST [ 22 , 23 , 26 , 27 , 28 , 29 , 30 , 32 , 34 , 36 , 37 , 38 , 39 , 40 , 41 ]. Of these studies, 11 performed the IGRA using the QFT method [ 22 , 23 , 26 , 28 , 30 , 32 , 36 , 37 , 38 , 40 , 41 ] and 2 used the T-SPOT method [ 27 , 34 ], whereas 1 performed IGRA using both the QFT and T-SPOT [ 29 ]. The remaining study did not provide information about the type of IGRA method [ 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…The remaining study did not provide information about the type of IGRA method [ 39 ]. Additionally, 11 studies reported TST-positive rates according to the IST [ 22 , 23 , 26 , 28 , 29 , 32 , 35 , 37 , 38 , 40 , 41 ]. Among them, 7 used different cutoff values according to the risk of TB to determine a TST-positive result [ 22 , 23 , 26 , 32 , 37 , 38 , 41 ], whereas the other 4 used 5 mm as a cutoff value regardless of TB risk [ 28 , 29 , 35 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Park

Jung

2022

JPM

View full text Add to dashboard Cite

Screening for latent tuberculosis infection (LTBI) is mandatory before commencing tumor necrosis factor (TNF)-α inhibitor use. However, the impact of immunosuppressive therapy (IST), including corticosteroids and immunomodulators, on the performance of LTBI screening in patients with inflammatory bowel disease (IBD) has not been fully elucidated. We searched all relevant studies published before November 2021 that examined the performance of interferon γ release assays (IGRAs) and tuberculin skin tests (TSTs) in patients with IBD who received IST, using the Medline, EMBASE, and Cochrane Library databases. We performed meta-analyses of positive or indeterminate rates of IGRA or TST according to IST and calculated the concordance rates between IGRA and TST results. A total of 20 studies with 4045 patients were included in the meta-analysis. The IGRA-positive rate was lower in patients on IST than in those not on IST (odds ratio (OR) (95% confidence interval (CI)) = 0.55 (0.39–0.78)), whereas the IGRA-indeterminate rate was higher in patients on IST than in those not on IST (OR (95% CI) = 2.91 (1.36–6.24)). The TST-positive rate did not differ between the on-IST and not-on-IST groups (OR (95% CI) = 0.87 (0.51–1.50)). The concordance rate between IGRA and TST was 83.3% (95% CI, 78.5–88.1%). The IGRA-negative/TST-positive rate tended to be higher than that the IGRA-positive/TST-negative rate (9.5% vs. 5.8%, respectively), although the difference was not statistically significant. In conclusion, IGRA results were negatively affected by IST in patients with IBD, supporting requirements that IGRA should be performed before initiating IST. The use of both an IGRA and TST in patients with IBD on IST may improve the diagnosis rate of LTBI.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Park

Jung

2022

JPM

View full text Add to dashboard Cite

show abstract

“…The airway is a gateway for the bacilli, which translocate to the respiratory tract after inhalation, where it finds the macrophage alveoli[ 12 ]. Dendritic cells or inflammatory monocytes transport Mbt to the pulmonary lymph nodes to initiate T cell stimulation of TNFα and interferon gamma secretion, which contribute to granuloma formation[ 12 , 13 ]. Granulomas are characteristic of human TB and are composed of clusters of macrophages and multinucleated giant cells that are surrounded by newly recruited monocyte/macrophage aggregates, neutrophils and lymphocytes[ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America

Fortes

Sorte

Mariano

et al. 2020

WJG

View full text Add to dashboard Cite

BACKGROUND There has been an increase in cases of inflammatory bowel disease (IBD) in recent years. There is also greater access and availability of immunosuppressive and biological agents, which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal healing. Tuberculosis (TB) remains a public health problem, and it has a high incidence in several countries. Therefore, knowledge of the risk of developing TB in patients with IBD is important. AIM To evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin America. METHODS A standard questionnaire included demographic variables, clinical aspects of IBD disease, history of active TB during treatment, active TB characteristics and evolution, initial screening and results and time from the start of anti-tumor necrosis factor alpha (TNFα) to TB development. RESULTS Azathioprine, anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB incidence. The TNFα blockers increased the relative risk of developing active TB compared to other treatments. All four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active TB. After adjustment for sex, age, type of IBD and latent TB, anti-TNFα with azathioprine increased the relative risk to 17.8 times more than conventional treatment. Late TB, which was diagnosed 3 mo after the start of anti-TNFα, was the most frequent. CONCLUSION Treatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin America. This risk was increased when anti-TNFα was combined with azathioprine. The time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.

show abstract

Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) on screening and treatment of tuberculosis infection in patients with inflammatory bowel disease

Riestra

Taxonera

Zabana

et al. 2021

Gastroenterología y Hepatología (English Edition)

View full text Add to dashboard Cite

Screening for latent tuberculosis infection in patients with inflammatory bowel disease: Can interferon-gamma release assays replace the tuberculin skin test?

Cited by 5 publications

References 34 publications

Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America

Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) on screening and treatment of tuberculosis infection in patients with inflammatory bowel disease

Contact Info

Product

Resources

About