结核菌素皮试和QuantiFERON-TB金管试验在抗肿瘤坏死因子治疗开始前诊断潜伏性结核感染。

Ho-Cheol Kim, Kyung-Wook Jo, Young Ju Jung, Bin Yoo, Chang-Keun Lee, Yong-Gil Kim, Suk-Kyun Yang, Jeong-Sik Byeon, Kyung-Jo Kim, Byong Duk Ye, Tae Sun Shim
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引用次数: 28

摘要

背景:潜伏性结核感染(LTBI)再激活是肿瘤坏死因子-α (TNF-α)阻滞剂治疗患者的一个重要并发症。然而,在抗tnf治疗开始前检测LTBI的最佳方法仍有待确定。方法:2010年1月至2013年8月,对426例免疫介导性炎症性疾病(IMIDs)患者进行抗tnf治疗。在开始抗tnf治疗前进行结核菌素皮肤试验(TST)和Quantiferon-TB金管(QFT-GIT)试验。LTBI被定义为TST阳性(硬化≥10 mm)或QFT-GIT阳性结果。患者随访至2013年12月。结果:TST阳性率为22.3% (95/426),QFT-GIT阳性率为16.0% (68/426),LTBI阳性率为27.0%(115/426)。开始LTBI治疗的患者占25.1%(107/426),完成LTBI治疗的患者占100%(107/107)。在中位294天的随访期间,基线TST和QFT-GIT结果阴性的患者中有1.4%(6/426)发生活动性结核病。结论:在IMIDs患者开始抗tnf治疗前,使用TST和QFT-GIT检测两种检测阳性策略均可用于LTBI筛查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosis of latent tuberculosis infection before initiation of anti-tumor necrosis factor therapy using both tuberculin skin test and QuantiFERON-TB Gold In Tube assay.

Background: Reactivation of latent tuberculosis infection (LTBI) is an important complication in patients treated with tumor necrosis factor-alpha (TNF-α) blocking agents. However, the best method for LTBI detection before initiation of anti-TNF therapy remains to be determined.

Methods: From January 2010 to August 2013, anti-TNF therapy was initiated in 426 patients with immune-mediated inflammatory diseases (IMIDs). Tuberculin skin test (TST) and Quantiferon-TB Gold In Tube (QFT-GIT) assay were performed before starting anti-TNF treatment. LTBI was defined as a positive TST (induration ≥ 10 mm) or as a positive QFT-GIT result. Patients were followed up until December 2013.

Results: The positive TST and QFT-GIT rates were 22.3% (95/426) and 16.0% (68/426), respectively, yielding a total of 27.0% (115/426) of positive LTBI results. LTBI treatment was initiated in 25.1% (107/426) and was completed in 100% (107/107) of patients. During a median 294 days of follow-up, active TB occurred in 1.4% (6/426) of the patients with negative TST and QFT-GIT results at baseline.

Conclusion: The either test positive strategy, using both TST and QFT-GIT assay, is acceptable for LTBI screening before commencing anti-TNF therapy in patients with IMIDs.

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