title: Immunodiagnostic Tests' Predictive Values for Progression to Tuberculosis in Transplant Recipients: A Prospective Cohort Study.
abstract: BACKGROUND
  Little is known about the predictive value for progression to tuberculosis (TB) of interferon-γ release assays and how they compare with the tuberculin skin test (TST) in assessing the risk of TB infection in transplant recipients.
  
  
  METHODS
  We screened 50 liver transplant (LT) and 26 hematopoietic stem cell transplant (HSCT) recipients with both QuantiFERON-TB Gold In-tube (QFT-GT) and TST and prospectively followed them for a median of 47 months without preventive chemoprophylaxis.
  
  
  RESULTS
  In the LT cohort, 1 in 22 (4.5%) QFT-GT-positive patients developed posttransplant TB, compared with none of the QFT-GT-negative patients. In the HSCT cohort, none of the 7 QFT-GT-positive patients developed TB, whereas 1 case (5.3%) progressed to active TB among the 19 QFT-GT-negative patients. Comparable results were obtained with the TST: in the LT group, 1 of 23 TST-positive and none of the 27 TST-negative patients developed TB; and in the HSCT group, none of the 8 TST-positive and one of the 18 TST-negative patients progressed to active TB.
  
  
  CONCLUSIONS
  In this cohort of transplant recipients, the positive predictive value of QFT-GT for progression to active TB was low and comparable to that of TST. Although the risk of developing TB in patients with negative results at baseline is very low, some cases may still occur.
authors: Departments of Infectious Diseases, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.; Department of Clinical Sciences, University of Barcelona, Barcelona, Spain.
authors: Laura
authors: L
authors: Muñoz
authors: Departments of Infectious Diseases, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors: Aina
authors: A
authors: Gomila
authors: Department of Internal Medicine, Consorci Sanitari Integral-Dos de Maig Hospital, Barcelona, Spain.
authors: Susana
authors: S
authors: Casas
authors: Department of Gastroenterology and Liver Transplant Unit, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors: José
authors: J
authors: Castellote
authors: Department of Hematology, Duran i Reynals Hospital, Barcelona, Spain.
authors: Montserrat
authors: M
authors: Arnan
authors: Department of General Surgery and Liver Transplant Unit, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors: Antoni
authors: A
authors: Rafecas
authors: Departments of Infectious Diseases, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.; Department of Clinical Sciences, University of Barcelona, Barcelona, Spain.
authors: Miguel
authors: M
authors: Santin