title: Comparison of Quantiferon-TB Gold versus tuberculin skin test for tuberculosis screening in inflammatory bowel disease patients.
abstract: OBJECTIVE
  Screening for latent tuberculosis (LTB) is recommended before starting anti-TNF-alpha therapy. We compared the performance of Quantiferon-TB Gold (QFT-G) with the tuberculin skin test (TST) for the screening of LTB in a population of inflammatory bowel disease (IBD) patients who were candidates for anti-TNF-α therapy.
  
  
  METHODS
  Ninety-two IBD patients who were candidates for anti-TNF-α therapy were tested with QTF-G and TST. Concomitant therapy and laboratory parameters were recorded.
  
  
  RESULTS
  One subject was vaccinated with Bacille Calmette Guèrin (BCG), 76% of patients were on immunosuppressive therapy (IST), and all patients had a negative TB history and negative chest X-ray. Agreement between the two tests was observed in 89.2% of patients (79.4% +/+, 9.8% -/-), QFT-G+/TST- was observed in 4.4% (4) patients, and QFT-G-/TST+ was observed in 5.5%, one of which was previously vaccinated. All disagreements were observed in patients on IST (14.3% in this group). The agreement analysis showed moderate strength among the patients (k=0.508), while the agreement was only fair in the subgroup of patients on IST (k=0.388).
  
  
  CONCLUSIONS
  Given the high risk of LTB reactivation in patients subjected to anti-TNF-α therapy, our results suggest that in our population, with low TB rate and very low BCG vaccination rate, both tests could be employed.
authors.affiliation: Department of Gastroenterology CIC, Catholic University, Via Moscati 31-33, 00168 Rome, Italy. lguidi@rm.unicatt.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Andrisani
authors.forename: Alessandro
authors.initials: A
authors.lastname: Armuzzi
authors.forename: Alfredo
authors.initials: A
authors.lastname: Papa
authors.forename: Manuela
authors.initials: M
authors.lastname: Marzo
authors.forename: Carla
authors.initials: C
authors.lastname: Felice
authors.forename: Daniela
authors.initials: D
authors.lastname: Pugliese
authors.forename: Italo
authors.initials: I
authors.lastname: De Vitis
authors.forename: Gian Lodovico
authors.initials: GL
authors.lastname: Rapaccini
authors.forename: Luisa
authors.initials: L
authors.lastname: Guidi
mesh_terms: D000328:Adult; D001500:BCG Vaccine; D000075202:Contraindications; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy; D059425:Interferon-gamma Release Tests / Q000379:methods*; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008403:Mass Screening / Q000379:methods; D011446:Prospective Studies; D015203:Reproducibility of Results; D014374:Tuberculin Test / Q000379:methods*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D001500:BCG Vaccine; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha