title: Serial testing of interferon-gamma-release assays for the diagnosis of latent tuberculosis in hemodialysis patients.
abstract: BACKGROUND
  The performance of serial interferon-gamma-release assays (IGRAs) for the diagnosis of latent tuberculosis has not been studied in hemodialysis patients.
  
  
  METHODS
  The QuantiFERON-TB-Gold In-Tube test (QFT) and T-SPOT-TB test (TSPOT) were performed 1 year after initial testing at a hemodialysis center.
  
  
  RESULTS
  Ninety-eight patients were included in the final analysis. Positive rates for the initial tuberculin skin test (TST), QFT and TSPOT were 26.5%, 43.9% and 58.2%, respectively. The follow-up QFT and TSPOT showed positive responses in 52.0% and 53.1%. Conversion rates of the QFT and TSPOT were 20.0% and 26.8%. Reversion rates of the QFT and TSPOT were 16.3% and 29.8%; however, they decreased to 0.0% and 4.8% in patients with a concordantly positive response at the initial TST. A group at high risk for latent tuberculosis increased the risk for the TSPOT conversion [odds ratio (95% confidence interval), 7.76 (1.27-47.40)] and showed a trend of increasing the risk for the QFT conversion [1.97 (0.45-8.71)]. Reversion of both the QFT [18.92 (2.01-178.65)] and TSPOT [6.16 (1.57-24.19)] occurred more frequently in the group at low risk.
  
  
  CONCLUSIONS
  Both conversion and reversion of the IGRAs were associated with the risk for latent tuberculosis in hemodialysis patients. However, serial IGRAs results should be interpreted cautiously due to their high variability.
authors.affiliation: Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Chung
authors.forename: Zhen Long
authors.initials: ZL
authors.lastname: Zheng
authors.forename: Hyung-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Jin-Woong
authors.initials: JW
authors.lastname: Park
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Lee
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Chang
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Jeong
authors.forename: Sejoong
authors.initials: S
authors.lastname: Kim
authors.forename: Hyun Hee
authors.initials: HH
authors.lastname: Lee
authors.forename: Jaeseok
authors.initials: J
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007371:Interferon-gamma / Q000378:metabolism*; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications* / Q000628:therapy*; D055815:Young Adult
chemical_list: D007371:Interferon-gamma