title: Detection of latent tuberculosis infection in rheumatologic diseases before anti-TNFα therapy: tuberculin skin test versus IFN-γ assay.
abstract: We aimed to evaluate tuberculin skin test (TST) and interferon-gamma (IFN-γ) test results for latent tuberculosis infection (LTBI) in patients with rheumatologic diseases prior to anti-TNFα therapy. Ninety patients were evaluated in the study at the Departments of Chest Diseases and Rheumatology for anti-TNFα therapy for their rheumatologic diseases. Tuberculin skin test was performed (Mantoux method) and peripheral blood samples were collected for IFN-γ assay (QuantiFeron TB-Gold In Tube) before the anti-TNFα therapy. Of 90 patients, TST positivity was detected in 56 (62.2%) patients, while IFN-γ positivity was detected in 34 (37.8%) patients. Among 56 TST positive patients, IFN-γ positivity was detected in 24 (42.9%) patients, and among 34 TST negative patients, IFN-γ positivity was detected in 10 (29.4%) patients. There was no significant agreement between TST and IFN-γ assay results (Kappa = 0.12, P = 0.2). Forty-three (47.8%) patients were using immunosuppressive drugs owing to their rheumatologic diseases. In this group, TST and IFN-γ positivity is significantly lower than in those who did not receive immunosuppressive treatment (P < 0.05). We conclude that the IFN-γ assay may not be preferred to TST as a diagnostic test in patients with rheumatologic diseases prior to anti-TNFα treatment.
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, University of Cukurova, 01330 Balcali, Adana, Turkey. ihanta@cu.edu.tr
authors.forename: Ismail
authors.initials: I
authors.lastname: Hanta
authors.forename: Suleyman
authors.initials: S
authors.lastname: Ozbek
authors.forename: Sedat
authors.initials: S
authors.lastname: Kuleci
authors.forename: Gulsah
authors.initials: G
authors.lastname: Seydaoglu
authors.forename: Ezgi
authors.initials: E
authors.lastname: Ozyilmaz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D055985:Latent Tuberculosis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012216:Rheumatic Diseases / Q000097:blood / Q000150:complications*; D014374:Tuberculin Test
chemical_list: D007371:Interferon-gamma
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