TST, QuantiFERON-TB Gold test and T-SPOT.TB test for detecting latent tuberculosis infection in patients with rheumatic disease prior to anti-TNF therapy
TST, QuantiFERON-TB Gold test and T-SPOT.TB test for detecting latent tuberculosis infection in patients with rheumatic disease prior to anti-TNF therapy
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DOI：
10.5578/tt.66122
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发表时间：
2018-01-01
影响因子：
1.1
通讯作者：
Dogan, Hakan
中科院分区：
文献类型：
--
作者：
Sargin, Gokhan;Senturk, Taskin;Dogan, Hakan
简介：在开始使用肿瘤坏死因子（TNF）-α阻断剂之前，应使用标准试验诊断结核感染。传统的结核菌素皮试（TST）在免疫抑制患者中的特异性较低，这是由于先前接种卡介苗（BCG）、非结核分枝杆菌感染、假阳性和假阴性结果。在这项研究中，我们的目的是比较TST和干扰素-γ释放试验（IGRA）检测潜在的结核感染的风湿性疾病患者计划接受TNF-α blockingagents.Materials和方法：109例（45男，64女）诊断类风湿关节炎（RA）（n=70）和强直性脊柱炎（AS）（n=39）被纳入本研究。年龄、性别、BCG疤痕数量、TST（使用Mantoux方法）、QuantiFERON-TB Gold试验和T-SPOT结果。记录所有患者的结核病检查结果。结果：RA和AS患者的平均年龄为50 ± 13岁（19-78岁）。与以密切接触活动性结核感染和/或胸部X线可疑纤维化/钙化病变而无活动性结核感染的复合标准相比，TST、QuantiFERON-TB Gold和T-SPOT.TB检测的潜伏性结核患病率分别为43.1%、39.4%和13.8%。BCG瘢痕数与TST呈中度相关（p
Introduction: Before starting tumour necrosis factor (TNF)-alpha blocking agents, standard tests should be used for the diagnosis of tuberculosis infection. The specificity of traditional tuberculin skin test (TST) is low in immunosuppressed patients due to prior Bacille Calmette Guerin (BCG) vaccination, non-tuberculous mycobacteria infections, false positive and negative results. In this study, we aimed to compare TST and Interferon-Gamma Release Assay (IGRA) tests for detecting latent tuberculosis infection in patients with rheumatic disease planned to receive TNF-alpha blocking agents.Materials and Methods: One hundred and nine patients (45 male, 64 female) with the diagnosis of rheumatoid arthritis (RA) (n=70) and ankylosing spondylitis (AS) (n=39) were included in the study. Age, sex, number of BCG scar, results of TST (using the Mantoux method), QuantiFERON-TB Gold test and T-SPOT. TB test were recorded for all patients. Correlation between the tests was assessed by Pearson correlation coefficient.Results: The mean age of RA and AS patients were 50 +/- 13 (19-78 years). The prevalence of latent tuberculosis was 43.1% for TST, 39.4% for QuantiFERON-TB Gold test and 13.8% for T-SPOT.TB test, compared with the evaluation using the composite criteria such as close contact with active tuberculosis infection and/or suspicious fibrotic/calcific lesions on chest X-Ray without active tuberculosis infection. There was a moderate correlation between BCG scar number and TST (p