|Title:||Dynamic changes in positive interferon-gamma release assay in a dialysis population: An observational cohort study||Authors:||Shu C.-C.
|Issue Date:||2013||Journal Volume:||67||Journal Issue:||6||Start page/Pages:||529-535||Source:||Journal of Infection||Abstract:||
Background: Interferon-gamma release assay (IGRA) is popular for detecting latent tuberculosis infection (LTBI), but its dynamic change is uncertain in high-risk groups such as dialysis patients. Methods: Patients undergoing dialysis were prospectively enrolled. The QuantiFERON-TB Gold In-Tube (QFT-GIT) was used to detect LTBI. After 6 and 12 months, QFT-GIT was repeated to monitor dynamic changes. Results: Only 204 of 391 enrolled patients completed the study. The initial QFT-GIT positive rate of 22.1% decreased to 19.6% after 6 months and to 14.2% after 12 months. The 6-month reversion rate was 45.9% while the conversion rate was 7.7%. Sub-population with new QFT-GIT positivity had 87.5% reversion rate, higher than the 20.8% of patients with persistent QFT-GIT positivity. The QFT-GIT response was independently associated with persistent QFT-GIT positivity. Using 0.93IU/ml of the initial QFT-GIT response as the threshold can detect 79% persistent positivity in 6-month follow-up. Prior TB had a borderline significance for predicting conversion. Conclusions: In the dialysis population, reversion and conversion occur frequently within six months. The QFT-GIT positive population is heterogeneous and sub-populations have different reversion rates. Higher QFT-GIT positivity threshold can identify patients with persistent QFT-GIT positivity to prioritize follow-up and LTBI therapy. ? 2013 The British Infection Association.
|ISSN:||0163-4453||DOI:||10.1016/j.jinf.2013.07.029||metadata.dc.subject.other:||adult; article; clinical trial; cohort analysis; diagnostic equipment; diagnostic value; female; follow up; hemodialysis patient; human; interferon gamma release assay; latent tuberculosis; major clinical study; male; observational study; outcome assessment; prospective study; Conversion; Dialysis; Interferon-gamma release assay; Latent tuberculosis infection; Reversion; Aged; Female; Humans; Interferon-gamma Release Tests; Latent Tuberculosis; Male; Middle Aged; Multivariate Analysis; Prospective Studies; Renal Dialysis
|Appears in Collections:||醫學系|
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