title: Diagnosis of tuberculosis infection by tuberculin skin test and a whole-blood interferon-γ release assay in patients considered for anti-tumor necrosis factor-α therapy.
abstract: To assess the performance of QuantiFERON®-TB Gold in-Tube (QFT-GIT; Cellestis, Carnegie, Australia) and tuberculin skin test (TST) in patients with immune-mediated inflammatory diseases (IMID), before anti-tumor necrosis factor-α (TNF-α) therapy, and to compare the results with those from the healthy population. Three hundred fourteen subjects (214 with IMID and 100 controls) underwent simultaneous QFT-GIT and TST. QFT-GIT was positive in 21% of IMID patients and in 16% of controls (P = 0.29). Among IMID patients, 21% tested positive by QFT-GIT and 24%, by TST (P = 0.30). Positive QFT-GIT results were not affected by immunosuppressive therapy (odds ratio, 0.78; 95% confidence interval [CI], 0.36-1.68; P = 0.52). Agreement between both tests in those patients who tested positive by one of the tests was 50% (95% CI, 37.2-62.8). QFT-GIT is useful for identifying IMID patients requiring treatment of latent tuberculosis before anti-TNF therapy. However, given the poor agreement between TST and QFT-GIT, we advocate a strategy of simultaneous testing to optimize diagnostic sensitivity.
authors.affiliation: Infectious Diseases Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Casas
authors.forename: Ana
authors.initials: A
authors.lastname: Andreu
authors.forename: Xavier
authors.initials: X
authors.lastname: Juanola
authors.forename: Xavier
authors.initials: X
authors.lastname: Bordas
authors.forename: Fernando
authors.initials: F
authors.lastname: Alcaide
authors.forename: Raquel
authors.initials: R
authors.lastname: Moure
authors.forename: Luis
authors.initials: L
authors.lastname: Anibarro
authors.forename: Eva
authors.initials: E
authors.lastname: Cuchí
authors.forename: Maria
authors.initials: M
authors.lastname: Esteve
authors.forename: Vera
authors.initials: V
authors.lastname: Ortiz
authors.forename: Maria Rosario
authors.initials: MR
authors.lastname: Guerra
authors.forename: Jesus
authors.initials: J
authors.lastname: Rodríguez
authors.forename: Delia
authors.initials: D
authors.lastname: Reina
authors.forename: Georgina
authors.initials: G
authors.lastname: Salvador
authors.forename: Jordi
authors.initials: J
authors.lastname: Guardiola
authors.forename: Xavier
authors.initials: X
authors.lastname: Surís
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Pascual
authors.forename: Carmina
authors.initials: C
authors.lastname: Martí
authors.forename: Xavier
authors.initials: X
authors.lastname: Martínez-Lacasa
authors.forename: Jordi
authors.initials: J
authors.lastname: Cuquet
authors.forename: Lucia
authors.initials: L
authors.lastname: Gonzalez
authors.forename: Miguel
authors.initials: M
authors.lastname: Santin
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007165:Immunosuppression Therapy; D059425:Interferon-gamma Release Tests; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D007155:Immunologic Factors; D014409:Tumor Necrosis Factor-alpha