title: Serial interferon-gamma release assays for latent tuberculosis in dialysis patients with end stage renal disease in a Korean population.
abstract: BACKGROUND
  Serial interferon-gamma-release-assay (IGRA) result can show variance due to within-subject variation and difference in host immune status, and may be affected by latent tuberculosis infection (LTBI) treatment. We aimed to know the changes in QFT-IT (QuantiFERON-TB Gold In-Tube) results measured at a 4 month interval in end stage renal disease patients and whether these changes were influenced by dialysis method or LTBI treatment.
  
  
  METHODS
  We prospectively performed serial QFT-IT tests at 4 month interval in 93 end stage renal disease (ESRD) patients on HD (hemodialysis) or PD (peritoneal dialysis). LTBI treatment was given to 18 of 39 patients with initial positive QFT-IT result. Agreement between the two results was estimated for all 93 patients and reversion rates were estimated among the 39 patients with initial positive QFT-IT.
  
  
  RESULTS
  Positive QFT-IT at the first and 2(nd) tests were 41.9 and 34.4 %, respectively. The concordance rate between baseline QFT-IT and 2(nd) QFT in 93 ESRD patients was excellent (90.3 %, kappa = 0.80, p < 0.001). Agreement between the first QFT-IT and 2(nd) QFT-IT in HD (95.3 %, kappa = 0.91, p < 0.001) was higher than in PD patients (86.0 %, kappa = 0.69, p < 0.001). Among all ESRD patients, the odds of reversion of QFT-IT was not different in those who were, or were not treated for LTBI [odds ratio = 2.3 (0.5-11.4), p = 0.43].
  
  
  CONCLUSIONS
  In a group of 93 dialyzed ESRD patients 8.6 % showed reversion of initial positive QFT to negative within 4 months. Reversion seemed not to be associated with LTBI treatment. Further study with larger numbers of patients is needed to investigate the variation of QFT-IT tests in dialyzed ESRD patients.
authors.affiliation: Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, 425-707, Republic of Korea. lee-sh@korea.ac.kr.
authors.forename: Seung Heon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Korean Institute of Tuberculosis, Cheongwongun, 363-954, Republic of Korea. hatchingbird@gmail.com.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, 614-735, Republic of Korea. psjgenesis@hanmail.net.
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, 614-735, Republic of Korea. thkim@paik.ac.kr.
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, 614-735, Republic of Korea. thwjd76@hanmail.net.
authors.forename: So Jeong
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, 614-735, Republic of Korea. kswnephrology@hotmail.com.
authors.forename: Sun Woo
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, 614-735, Republic of Korea. yeonghnl@inje.ac.kr.
authors.forename: Yeong Hoon
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, QC, H2X 2P4, Canada. Dick.Menzies@Mcgill.ca.
authors.forename: Dick
authors.initials: D
authors.lastname: Menzies
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003710:Demography; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D059425:Interferon-gamma Release Tests; D007676:Kidney Failure, Chronic / Q000150:complications; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D006435:Renal Dialysis; D015203:Reproducibility of Results; D056910:Republic of Korea
chemical_list: D007371:Interferon-gamma