title: Validity of interferon-γ-release assays for the diagnosis of latent tuberculosis in haemodialysis patients.
abstract: Haemodialysis patients are at higher risk of developing active tuberculosis (TB) infection. However, tuberculin skin tests (TST) have limitations and the diagnostic usefulness of interferon-γ-release assays (IGRAs) remains unclear in immunocompromised hosts including haemodialysis patients. Haemodialysis patients were enrolled from a dialysis centre in Korea, an intermediate TB-burden country with a high bacille Calmette-Guérin (BCG) vaccination rate. The QuantiFERON-Gold TB In tube test (QFT) and the T-SPOT TB test (TSPOT) were performed, along with the TST. We stratified patients to low- and high-risk groups, according to the risk factors for latent TB. Association between each of the three diagnostic tests and the risk of latent TB was analysed. One hundred and sixty-seven patients were enrolled. The positive rates for the TST, the QFT and TSPOT were 23.5, 45.9 and 60.4%, respectively. Previous BCG vaccination increased the TST-positive rate in the low-risk group (OR 4.438), whereas it affected neither QFT nor TSPOT. The positive QFT rates were 41.2 and 62.5% in the low- and high-risk groups, respectively. The QFT was associated with the high-risk group (OR 2.578), whereas the TST was not. The positive TSPOT rates were 58.9 and 65.7% in the low- and high-risk groups, respectively. The frequency of indeterminate results was higher for the QFT (12.6%) compared with the TSPOT (4.8%). In conclusion, the IGRAs can be useful for the diagnosis of latent TB infection in haemodialysis patients.
authors.affiliation: Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: W K
authors.initials: WK
authors.lastname: Chung
authors.forename: Z L
authors.initials: ZL
authors.lastname: Zheng
authors.forename: J Y
authors.initials: JY
authors.lastname: Sung
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.forename: H H
authors.initials: HH
authors.lastname: Lee
authors.forename: S J
authors.initials: SJ
authors.lastname: Choi
authors.forename: J
authors.initials: J
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007371:Interferon-gamma / Q000097:blood*; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications* / Q000382:microbiology; D015203:Reproducibility of Results; D012307:Risk Factors; D014374:Tuberculin Test; D055815:Young Adult
chemical_list: D001500:BCG Vaccine; D011933:Reagent Kits, Diagnostic; D007371:Interferon-gamma