title: Predictive value of the tuberculin skin test and QuantiFERON-tuberculosis Gold In-Tube test for development of active tuberculosis in hemodialysis patients.
abstract: BACKGROUND
  Hemodialysis (HD) patients are at increased risk of reactivation of latent tuberculosis infection (LTBI) compared with the general population. QuantiFERON-TB Gold (QFT-G) for LTBI detection is more promising than tuberculin skin test (TST) in HD patients.
  
  
  OBJECTIVE
  In our study, we evaluated the value of the TST and QFT-G In-Tube (QFG-IT) test in the development of active tuberculosis (TB), in the HD patients, and in healthy controls.
  
  
  METHODS
  The study enrolled 95 HD patients and ninety age-matched, healthy controls. The TST and QFG-IT were performed. All the subjects were followed up 5 years for active TB disease.
  
  
  RESULTS
  Compared to the healthy controls, a high prevalence of LTBI was found in the HD patients by QFG-IT (41% vs. 25%). However, no significant difference was detected by TST (32% vs. 31%). Four HD patients and one healthy control progressed to active TB disease within the 5-year follow-up. For active TB discovered subjects, QFG-IT was positive in all, but TST was positive in two (one patient and one healthy control). In HD patients; sensitivity, specificity, positive and negative predictive values of QFG-IT, and TST for active TB was 100% and 25%, 62% and 67%, 10%, and 3%, and 100% and 95%, respectively. Receiver operating curve analysis revealed that the results are significantly different (P = 0.04).
  
  
  CONCLUSIONS
  QFG-IT test is a more useful diagnostic method than TST for detecting those who will progress to active TB in HD patients.
authors.affiliation: Department of Chest Diseases, Medical Faculty, Medipol University, Istanbul, Turkey.
authors.forename: Ekrem Cengiz
authors.initials: EC
authors.lastname: Seyhan
authors.affiliation: Department of Chest Diseases, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Gulşah
authors.initials: G
authors.lastname: Gunluoglu
authors.affiliation: Department of Chest Diseases, Medical Faculty, Medipol University, Istanbul, Turkey.
authors.forename: Mehmet Zeki
authors.initials: MZ
authors.lastname: Gunluoglu
authors.affiliation: Department of Chest Diseases, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Seda
authors.initials: S
authors.lastname: Tural
authors.affiliation: Department of Chest Diseases, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Sinem
authors.initials: S
authors.lastname: Sökücü
keywords: Active tuberculosis; QuantiFERON-tuberculosis Gold In-Tube; healthy controls; hemodialysis patients; tuberculin skin test