title: Inflammatory markers and clinical characteristics for predicting persistent positivity of interferon gamma release assay in dialysis population.
abstract: The interferon-gamma release assay (IGRA) is useful for diagnosing latent tuberculosis infection (LTBI), however the rate of negative conversion is high, especially in dialysis patients. Few studies have focused on predicting persistently positive patients who are at high risk of tuberculosis reactivation. We screened dialysis patients, and used QuantiFERON-TB Gold In-tube (QFT-GIT) to identify LTBI. Of the 157 participants who had initially positive QFT-GIT, 82 had persistently positivity and 75 had negative conversion. The persistently positive group were younger, more were current smokers, and had higher plasma level of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and QFT-GIT responses than the negative conversion group. Multivariate logistic regression for persistent positivity revealed that high plasma sTREM-1 and QFT-GIT response, young age and TB contact history were independent factors. Currently smoking had borderline significance. The area under the receiver operating characteristic curve using the multi-factor model was 0.878, higher than 0.821 by QFT-GIT response of 0.95 IU/ml. In conclusion, dialysis patients with persistent LTBI status may be associated with a young age, high plasma sTREM-1, strong QFT-GIT response, currently smoking, and TB contact history. If resources are limited, these five predictors can be used to prioritize QFT-GIT-positive dialysis patients for LTBI treatment.
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Traumatology, National Taiwan University Hospital, Taipei city, Taiwan.|Department of Internal Medicine, National Taiwan University Hospital, Taipei city, Taiwan.
authors.forename: Chin-Chung
authors.initials: CC
authors.lastname: Shu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei city, Taiwan.
authors.forename: Chia-Lin
authors.initials: CL
authors.lastname: Hsu
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Taipei City, Taiwan.
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei city, Taiwan.
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin branch, Yun-Lin county, Taiwan.
authors.forename: Feng-Jung
authors.initials: FJ
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei city, Taiwan.
authors.forename: Jann-Yuan
authors.initials: JY
authors.lastname: Wang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei city, Taiwan.
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei city, Taiwan.|Department of Laboratory Medicine, National Taiwan University Hospital, Taipei city, Taiwan.
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Lee
mesh_terms: D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007371:Interferon-gamma / Q000097:blood*; D055985:Latent Tuberculosis / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D000073871:Triggering Receptor Expressed on Myeloid Cells-1 / Q000097:blood
chemical_list: D015415:Biomarkers; C573415:IFNG protein, human; D018836:Inflammation Mediators; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D007371:Interferon-gamma