title: Serial QuantiFERON TB-gold in-tube testing during LTBI therapy in candidates for TNFi treatment.
abstract: OBJECTIVE
  To evaluate the T-cell interferon (IFN)-γ response to Mycobacterium tuberculosis-specific antigens during latent tuberculosis infection (LTBI) therapy in candidates for tumor necrosis factor-α inhibitors (TNFi).
  
  
  METHODS
  1490 Patients were screened for LTBI. One-hundred and sixty-six of them were treated for LTBI and followed-up with QuantiFERON-TB Gold (QFT-IT) testing at baseline (T0) and therapy completion (T1); 92 subjects were also tested 3-6 months after therapy completion (T2).
  
  
  RESULTS
  At T1 the QFT-IT reversion and conversion rates were 24% (27/111) and 18% (10/55), respectively. By multivariate analysis, the likelihood of reversion significantly decreased with older age (>50-60), larger TST size (>15 mm) and higher IFN-γ value at T0 (>1 IU/ml); the likelihood of conversion increased with higher IFN-γ levels at T0 (1 IU/ml) and in female patients. Quantitative data among those who scored QFT-IT-positive at T0 showed a decreasing trend of IFN-γ levels between T0 and T1 that reached statistical significance when T0 was compared to T2, and T1 to T2.
  
  
  CONCLUSIONS
  The data confirm the difficulty of interpreting the modulation of IFN-γ levels during LTBI therapy. Currently, there is no evidence to support the use of QFT-IT in the clinical practice of monitoring LTBI treatment in candidates for TNFi.
authors.affiliation: SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Firenze, Italy. bartalesif@aou-careggi.toscana.it
authors.forename: Filippo
authors.initials: F
authors.lastname: Bartalesi
authors.forename: Delia
authors.initials: D
authors.lastname: Goletti
authors.forename: Michele
authors.initials: M
authors.lastname: Spinicci
authors.forename: Annalisa
authors.initials: A
authors.lastname: Cavallo
authors.forename: Letizia
authors.initials: L
authors.lastname: Attala
authors.forename: Jessica
authors.initials: J
authors.lastname: Mencarini
authors.forename: Ginevra
authors.initials: G
authors.lastname: Fiori
authors.forename: Francesca
authors.initials: F
authors.lastname: Li Gobbi
authors.forename: Antonia
authors.initials: A
authors.lastname: Mantella
authors.forename: Maurizio
authors.initials: M
authors.lastname: Benucci
authors.forename: Francesca
authors.initials: F
authors.lastname: Prignano
authors.forename: Nicola
authors.initials: N
authors.lastname: Pimpinelli
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci Cerinic
authors.forename: Enrico
authors.initials: E
authors.lastname: Girardi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bartoloni
mesh_terms: D000368:Aged; D000942:Antigens, Bacterial / Q000276:immunology*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D059425:Interferon-gamma Release Tests / Q000379:methods*; D055985:Latent Tuberculosis / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000942:Antigens, Bacterial; D014409:Tumor Necrosis Factor-alpha; C072681:Mycobacterium tuberculosis antigens; D007371:Interferon-gamma