title: The use of Quantiferon-TB gold in-tube test in screening latent tuberculosis among Saudi Arabia dialysis patients.
abstract: OBJECTIVE
  Screening for tuberculosis (TB) is a key strategy for controlling infection. This study aimed to detect latent TB among dialysis patients.
  
  
  METHODS
  This is a prospective study conducted in King Saud University, Riyadh involving hemodialysis (HD) and peritoneal dialysis (PD) patients aged ≥18 years. Patients were screened for latent TB infection (LTBI) using both TBskin test (TST) and QuantiFERONTB Gold In-Tube test (QFT-GIT). All participants were followed-up clinically and radiologically every 3 months for 2 years.
  
  
  RESULTS
  A total of 243 (181 HD and 62 PD) patients were included and 112(46.1%) were males. 45.3% showed positive QFT in HD patients with sensitivity of 91.7%, specificity of 71.4%, positive predictive value (PPV) of 19.5%, and negative predictive value (NPV) of 91.1%. TST results in HD showed that positive TST was 17.4%, sensitivity was 63.2%, specificity was 95.5%, PPV was 51.5%, and NPV was 91.1%. Five (8.1%) showed positive QFT in PD patients with sensitivity of 7.7%, specificity of 91.8%, PPV of 6.6%, and NPV of 92.3%. TST results in PD showed that positive TST was 9.8%, sensitivity was 35.7%, specificity was 97.9%, PPV was 55.8%, and NPV was 93.3%. Previous TB infection was significantly correlated with QFT only in HD patients, but significantly associated with TST in both HD and PD patients. Also in HD, QFT was significantly associated with TST (P = 0.043).
  
  
  CONCLUSIONS
  Due to high variability of QFT-GIT sensitivity, we recommend its use for its NPV and to use either TST or QFT in screening latent TB.
authors.affiliation: Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Jamal Saleh
authors.initials: JS
authors.lastname: Al Wakeel
authors.affiliation: Neurosurgery Department, The Ottawa Hospital-Civic Campus, The University of Ottawa, Ontario, Canada.
authors.forename: Ziyad
authors.initials: Z
authors.lastname: Makoshi
authors.affiliation: Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al Ghonaim
authors.affiliation: Nephrology Division, Security Forces Hospital, Riyadh, Saudi Arabia.
authors.forename: Ali
authors.initials: A
authors.lastname: Al Harbi
authors.affiliation: Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdulkareem
authors.initials: A
authors.lastname: Al Suwaida
authors.affiliation: Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Farjah
authors.initials: F
authors.lastname: Algahtani
authors.affiliation: Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Mogbil
authors.initials: M
authors.lastname: Al Hedaithy
authors.affiliation: Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Sultan
authors.initials: S
authors.lastname: Almogairin
authors.affiliation: College of Applied Studies and Community Service, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Sami
authors.initials: S
authors.lastname: Abdullah
keywords: Dialysis; King Abdulaziz City of Science and Technology; King Saud University; quantiferon; tuberculosis