title: Concordance of the tuberculin skin test and T-SPOT(®).TB test results in kidney transplant candidates.
abstract: BACKGROUND
  Detection of latent tuberculosis infection (LTBI) in transplant candidates is very important. The tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are standard immunologic tools for LTBI detection. The aim of this study was to compare the TST results and T-SPOT(®).TB test (a type of IGRAs) in kidney transplant candidates for the screening of LTBI and follow the patients with positive test for an activation of tuberculosis (TB) after transplantation and using anti-TB prophylaxis.
  
  
  METHODS
  This study was a prospective study and carried out in 44 renal transplant candidates from March 2010 to February 2011 in the teaching hospitals of Isfahan University of Medical Sciences, Iran. TST and T-SPOT(®).TB test were performed and their results evaluated. Patients with a positive skin test and/or T-SPOT(®).TB test were started on anti-TB prophylaxis and followed after transplantation for an activation of their LTBI for 1 year.
  
  
  RESULTS
  Overall, 8 (18.2%) patients were positive for TST and 6 (13.6%) patients for T-SPOT(®).TB test. The agreement between TST and T-SPOT(®).TB test was moderate (κ = 0.49, 95% confidence interval 0.145-0.839). The overall agreement between TST and T-SPOT(®).TB test was 86%. No relation was found between the underlying diseases and TST or T-SPOT(®).TB test positivity. Although isoniazid prophylaxis was used for patients with positive TST and/or T-SPOT(®).TB test, one patient had reactivation of TB.
  
  
  CONCLUSIONS
  In kidney transplant candidates both TST and T-SPOT(®).TB test were comparable for the diagnosis of LTBI with reasonable agreement between the tests. However, further studies are needed to determine the ability of T-SPOT(®).TB test to detect LTBI and to evaluate the need for prophylaxis in these patients.
authors.affiliation: Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Sherkat
authors.affiliation: Nosocomial Infections Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Yaran
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Shoaie
authors.affiliation: Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Mortazavi
authors.affiliation: Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Shahidi
authors.affiliation: Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Hamidi
authors.affiliation: Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Shiva
authors.initials: S
authors.lastname: Seirafian
authors.affiliation: Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Taheri
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ziba
authors.initials: Z
authors.lastname: Farajzadegan
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Soodabeh
authors.initials: S
authors.lastname: Rostami
keywords: Kidney transplant; T-SPOT®.TB test; latent tuberculosis; tuberculin skin test