title: Correlation between the response to Mycobacterium tuberculosis antigens and the tuberculin skin test in patients with rheumatoid arthritis in Colombia.
abstract: BACKGROUND
  Rheumatoid arthritis patients under treatment with anti-TNF-α are at a high risk of developing active tuberculosis, and therefore, screening for latent tuberculosis infection is recommended before anti-TNF-α therapy.
  
  
  OBJECTIVE
  To compare the tuberculin test and IFNγ production induced by culture filtrate proteins(CFPs) and Mycobacterium tuberculosis-specific CFP-10 antigens in rheumatoid arthritis patients.
  
  
  METHODS
  An analytic transversal study was conducted in rheumatoid arthritis patients treated at Hospital Universitario San Vicente Fundación between January and December 2007. IFNγ production in response to CFPs and CFP-10 was measured in the supernatants of whole blood cultures and evaluated for correlations with tuberculin reactivity. The degree of concordance between both tests was also established.
  
  
  RESULTS
  Forty-five patients were included, of which 14 (31.1%) had a tuberculin reaction of ≥10 mm of induration, 9 (20%) produced IFNγ in response to CFP-10, and 7 were positive for both tests. The correlation between tests was r=0.53 (IC 95%:0.28-0.72), and the global concordance between tests was80%, with a Kappa coefficient of 0.48 (IC95%:0.20-0.76).
  
  
  CONCLUSIONS
  Only two tuberculin (-)/CFP-10+ "anergic" patients were observed. By contrast, six tuberculin +/CFP-10(-) "tuberculin false-positive" patients were observed. These data suggest that the tuberculin test is not an appropriate tool for determining the need for tuberculosis prophylaxis.
authors.affiliation: Grupo de Inmunología Celular e Inmunogenética, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Yurika
authors.initials: Y
authors.lastname: López
authors.affiliation: Grupo de Reumatología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Francisco
authors.initials: F
authors.lastname: Vargas
authors.affiliation: Grupo de Reumatología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Mónica
authors.initials: M
authors.lastname: Velásquez
authors.affiliation: Grupo de Inmunología Celular e Inmunogenética, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Carolina
authors.initials: C
authors.lastname: Ortiz
authors.affiliation: Grupo de Inmunología Celular e Inmunogenética, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Libia M
authors.initials: LM
authors.lastname: Rodríguez
authors.affiliation: Grupo de Inmunología Celular e Inmunogenética, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Sara
authors.initials: S
authors.lastname: París
authors.affiliation: Grupo de Inmunología Celular e Inmunogenética, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Luis F
authors.initials: LF
authors.lastname: García
authors.affiliation: Grupo de Inmunología Celular e Inmunogenética, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Andrés
authors.initials: A
authors.lastname: Baena
authors.affiliation: Grupo de Reumatología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Gloria
authors.initials: G
authors.lastname: Vásquez
mesh_terms: D000328:Adult; D000942:Antigens, Bacterial / Q000494:pharmacology*; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications / Q000276:immunology*; D002478:Cells, Cultured; D003105:Colombia; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014374:Tuberculin Test; D014376:Tuberculosis / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis* / Q000187:drug effects*
chemical_list: D000942:Antigens, Bacterial; D014409:Tumor Necrosis Factor-alpha; C072681:Mycobacterium tuberculosis antigens