Detection of latent tuberculosis infection in rheumatologic diseases before anti-TNF alpha therapy: tuberculin skin test versus IFN-gamma assay

HANTA İ., ÖZBEK S., KULECİ S., SEYDAOĞLU G., ÖZYILMAZ E.

RHEUMATOLOGY INTERNATIONAL, vol.32, no.11, pp.3599-3603, 2012 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 11
  • Publication Date: 2012
  • Doi Number: 10.1007/s00296-011-2243-x
  • Journal Name: RHEUMATOLOGY INTERNATIONAL
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.3599-3603
  • Keywords: Latent tuberculosis, Interferon-gamma assays, Tuberculin skin test, Rheumatologic diseases, RELEASE ASSAYS, DIAGNOSIS, ARTHRITIS, RISK, AGENTS
  • Çukurova University Affiliated: Yes

Abstract

We aimed to evaluate tuberculin skin test (TST) and interferon-gamma (IFN-gamma) test results for latent tuberculosis infection (LTBI) in patients with rheumatologic diseases prior to anti-TNF alpha therapy. Ninety patients were evaluated in the study at the Departments of Chest Diseases and Rheumatology for anti-TNF alpha therapy for their rheumatologic diseases. Tuberculin skin test was performed (Mantoux method) and peripheral blood samples were collected for IFN-gamma assay (QuantiFeron TB-Gold In Tube) before the anti-TNF alpha therapy. Of 90 patients, TST positivity was detected in 56 (62.2%) patients, while IFN-gamma positivity was detected in 34 (37.8%) patients. Among 56 TST positive patients, IFN-gamma positivity was detected in 24 (42.9%) patients, and among 34 TST negative patients, IFN-gamma positivity was detected in 10 (29.4%) patients. There was no significant agreement between TST and IFN-gamma assay results (Kappa = 0.12, P = 0.2). Forty-three (47.8%) patients were using immunosuppressive drugs owing to their rheumatologic diseases. In this group, TST and IFN-gamma positivity is significantly lower than in those who did not receive immunosuppressive treatment (P < 0.05). We conclude that the IFN-gamma assay may not be preferred to TST as a diagnostic test in patients with rheumatologic diseases prior to anti-TNF alpha treatment.