Utility of QuantiFERON-TB Assay for Prediction of Tuberculosis Development in Kidney Transplant Patients in an Intermediate-Tuberculosis-Burden Country: Lack of Evidence for Enhanced Prediction for Short-Term Tuberculosis Development

Jeong, Jong Cheol; Koo, Taeryool; Jeon, Hee Jung; Park, H.C.; Ryu, Hee Jung; Lee, J.P.; Min, Seung-Kee; Hwang, Young Hwan; Ha, Jung-Eun; Ahn, Cheol‐Hee; Yang, Jaeseok

doi:10.1016/j.transproceed.2013.11.108

Cited by 24 publications

(21 citation statements)

References 14 publications

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“…Our extensive review of the literature identified four other detailed case reports that documented the development of active TB disease after LTBI treatment . In addition, we found a total of 56/2651 (2.1%) cases of active TB among 41 observational cohorts and six RCT . Among them, only five cases were described in detail.…”

Section: Resultsmentioning

confidence: 95%

“…We found 41 cohort studies that evaluated the outcome of LTBI therapy. Eleven were from Europe, 10 from US and Asia, seven from South America, and one each from Africa, Australia, and Canada . Only nine were prospective .…”

Section: Resultsmentioning

confidence: 99%

“…Only nine were prospective . Most studies included kidney (22) and liver (12) transplant recipients only. There were three studies on lung and four on multiple organ transplants .…”

Section: Resultsmentioning

confidence: 99%

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Treatment of latent TB Infection and the risk of tuberculosis after solid organ transplantation: Comprehensive review

Abad

Deziel

Razonable

2019

Transplant Infectious Dis

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Background: Mycobacterium tuberculosis disease may occur after treatment of latent TB infection (LTBI). Prompted by a case of reactivation TB disease in a solid organ transplant (SOT) recipient who received LTBI treatment, we reviewed the literature to examine outcomes, adverse effects, resistance, and treatment choices of tuberculosis after LTBI therapy.Methods: MEDLINE and Web of Science from inception to 5/2019 were reviewed using key words "latent tuberculosis infection" and "SOT" or "transplantation." The search yielded nine cases, 41 cohort studies and six randomized controlled trials (RCT). Results: Cohort and RCT demonstrated significant reduction in TB disease among transplanted patients who received LTBI therapy; only 56/2651 (2.1%) SOT patients developed TB after LTBI therapy. Adverse drug reactions occurred in 149/1148 (12.9%) and 73/641 (11.4%) of cohort and RCT patients, respectively. Among liver recipients, 56/266 (21%) developed side effects, of which half (29/56, 51.8%) was INH-related. There was no reported INH resistance. Conclusions: Latent TB infection treatment is efficacious in SOT recipients at risk of TB disease. However, tuberculosis may still occur despite LTBI treatment. Hepatotoxicity associated with LTBI therapy is infrequent, although more commonly observed among liver recipients. K E Y W O R D S latent TB, Mycobacterium tuberculosis, solid organ transplant

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

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Treatment of latent TB Infection and the risk of tuberculosis after solid organ transplantation: Comprehensive review

Abad

Deziel

Razonable

2019

Transplant Infectious Dis

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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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“…The TB burden of South Korea is decreasing, but the country is still classified as having an intermediate TB burden, with an annual TB incidence of 86/100,000 person-years in 2015 [7] and a TB incidence after KT of 0.283 cases/100 patient-years in a previous study [8]. The QuantiFERON-TB-Gold In-Tube test (QFT) (Cellestis Ltd., Carnegie, Victoria, Australia) was introduced at our center in 2009.…”

Section: Introductionmentioning

confidence: 99%

Poor predictability of QuantiFERON-TB assay in recipients and donors for tuberculosis development after kidney transplantation in an intermediate-TB-burden country

et al. 2017

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BackgroundTuberculosis (TB) is a common opportunistic infection after kidney transplantation (KT). The QuantiFERON-TB-Gold In-Tube test (QFT) is widely used for assessing latent TB; however, it is currently unclear whether the pre-KT QFT of the recipient and donor can predict post-KT TB.MethodsWe retrospectively reviewed patients who received KT between January 2009 and December 2015 at Seoul National University Hospital. The QFT was performed in 458 KT recipients and 239 paired living donors, and 138 KT recipients underwent both the QFT and tuberculin skin test (TST). After excluding 12 patients diagnosed as having clinically latent TB, we evaluated whether the QFT of the recipient and donor was predictive for new-onset active TB after KT.ResultsThe QFT was positive in 101 (22.1%) recipients and associated with clinically latent TB before KT (P < 0.05). However, agreement between the TST and QFT was poor (κ = 0.327). Post-KT TB occurred in 1 of 95 recipients with a positive QFT, and 2 cases of TB occurred among 351 patients with a negative or indeterminate QFT. The incidence of TB was 242 cases/100,000 person-years among 446 KT recipients with a median follow-up of 30.2 months. The QFT of recipients could not predict post-KT TB in Poisson regression analysis (relative risk [RR], 1.847; 95% confidence interval [CI], 0.168–20.373; P = 0.616). Of 234 living donor-recipient pairs, the QFT of the recipient (RR, 5.012; 95% CI, 0.301–83.430; P = 0.261) and QFT of the donor (RR, 1.758; 95% CI, 0.106–29.274; P = 0.694) could not predict post-KT TB.ConclusionThe QFT of recipients or living donors pre-KT cannot predict the short-term development of post-KT TB in an intermediate TB-burden country.

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Utility of QuantiFERON-TB Assay for Prediction of Tuberculosis Development in Kidney Transplant Patients in an Intermediate-Tuberculosis-Burden Country: Lack of Evidence for Enhanced Prediction for Short-Term Tuberculosis Development

Cited by 24 publications

References 14 publications

Treatment of latent TB Infection and the risk of tuberculosis after solid organ transplantation: Comprehensive review

Treatment of latent TB Infection and the risk of tuberculosis after solid organ transplantation: Comprehensive review

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

Poor predictability of QuantiFERON-TB assay in recipients and donors for tuberculosis development after kidney transplantation in an intermediate-TB-burden country

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