Evaluation of an interferon gamma assay in the diagnosis of latent tuberculosis infection in patients with rheumatoid arthritis.
The tuberculin skin test is not an ideal screening test for the patients with rheumatoid arthritis to identify cases of latent tuberculosis infection (LTBI) prior to the start of treatment with anti-TNFs, as it responds inadequately to late hypersensitivity, which is fundamental for producing a response to the inoculated antigen. Assays based on detection of the production of IFNγ in vitro by mononuclear peripheral cells stimulated by specific antigens are more specific than PPD in detecting LTBI. The aim of this study was to evaluate the performance of T-SPOT.TB in diagnosis of LTBI in patients with rheumatoid arthritis, comparing with the PPD. The specificity of the T-SPOT.TB varied from 87 to 90% and the negative-predictive value (NPV) from 94.4 to 100%. It can be concluded that the T-SPOT.TB showed high specificity and NPV, proving the capability of identifying false-negative cases of PPD, raising the level of safety for the use of anti-TNFs.
Escola Pernambucana de Medicina, FBV/IMIP, Rua dos Coelhos, 300 Recife, PE CEP 50070-550, Brazil. claudia_reumatologia@terra.com.br
Cláudia Diniz Lopes
CD
Marques
Ângela Luzia Branco Pinto
ÂL
Duarte
Virginia Maria Barros
VM
de Lorena
Joelma Rodrigues
JR
Souza
Wayner Vieira
WV
Souza
Yara de Miranda
Yde M
Gomes
Eduardo Maia Freese
EM
de Carvalho
D000328:Adult; D000942:Antigens, Bacterial / Q000276:immunology*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D015415:Biomarkers / Q000032:analysis; D001938:Brazil; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000276:immunology* / Q000382:microbiology; D014374:Tuberculin Test; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000378:metabolism
D000942:Antigens, Bacterial; D018501:Antirheumatic Agents; D015415:Biomarkers; D011933:Reagent Kits, Diagnostic; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma