The 'either test positive' strategy for latent tuberculous infection before anti-tumour necrosis factor treatment
The 'either test positive' strategy for latent tuberculous infection before anti-tumour necrosis factor treatment
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DOI：
10.5588/ijtld.13.0644
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发表时间：
2014-04-01
影响因子：
4
通讯作者：
Shim, T. S.
中科院分区：
文献类型：
--
作者：
Jung, Y. J.;Lee, J. Y.;Shim, T. S.
环境：韩国的一个三级转诊中心。结论：“要么检测阳性”策略，结合结核菌素皮肤试验（TST）和TSPOT（R）.TB（T-SPOT）试验，被评价为一种新的方法，用于在免疫介导的炎症性疾病患者中，在抗肿瘤坏死因子（TNF）治疗前诊断潜伏性结核感染（LTBI）。设计：从2008年6月至2012年4月，430例患者在我院接受抗TNF治疗。在基线时同时进行TST和T-SPOT。结果：TST和T-SPOT的阳性率分别为19.1%（82/430）和44.2%（190/430），LTBI的阳性率为48.6%（209/430）。46.0%（198/ 430）的患者开始了LTBI治疗，89.4%（177/ 198）的患者完成了治疗。在随访期间（中位数884天），0.9%（4/ 430）的患者发生活动性结核（TB）。所有四个TB患者TST阴性的基线，虽然两个收到LTBI治疗的基础上，基线阳性T-SPOT检测results.CONCLUSIONS：无论是测试阳性的战略是一个有效的方法诊断LTBI抗TNF治疗前，虽然目前还不清楚它是否是上级其他战略。
SETTING: A tertiary referral centre in South Korea.OBJECTIVES: The `either test positive' strategy, incorporating both the tuberculin skin test (TST) and the TSPOT (R).TB (T-SPOT) assay, was evaluated as a novel method for diagnosing latent tuberculous infection (LTBI) before treatment with anti-tumour necrosis factor (TNF) in patients with immune-mediated inflammatory diseases.DESIGN: From June 2008 to April 2012, 430 patients received anti-TNF treatment at our institution. TST and T-SPOT were performed simultaneously at baseline. LTBI was defined as a positive TST or a positive T-SPOT result.RESULTS: The positivity rates for the TST and T-SPOT assays were respectively 19.1% (82/430) and 44.2% (190/430), yielding an LTBI-positive rate of 48.6% (209/430). LTBI treatment was initiated in 46.0% (198/ 430) of patients and was completed by 89.4% (177/ 198). During follow-up (median 884 days), 0.9% (4/ 430) of the patients developed active tuberculosis (TB). All four TB patients were TST-negative at baseline, although two received LTBI treatment based on the baseline positive T-SPOT assay results.CONCLUSIONS: The either test positive strategy is a valid method for diagnosing LTBI before anti-TNF treatment, although it is not clear whether it is superior to other strategies.