Objectives: Screening for latent tuberculosis infection (LTBI) diagnosis is mandatory in patients with immune-mediated inflammatory diseases (IMID) requiring biologics. QuantiFERON-TB-Plus (QFT-P), an LTBI diagnostic test, measures IFN-γ after M. tuberculosis-stimulation in TB1 and TB2 tubes in which a “CD4” or a “CD4 and CD8” response is respectively elicited. Aim of this study is to compare the response to QFT-P of IMID-LTBI patients candidates to a new biological therapy vs LTBI-subjects without IMID. Methods: We prospectively enrolled 167 subjects: 61 IMID-LTBI and 106 NON-IMID-LTBI. Results: All subjects were mitogen-responders. IFN-γ production was significantly lower in IMID-LTBI-patients compared to NON-IMID-LTBI-subjects. We observed discordant TB1 and TB2 results in 6.5% of IMID-LTBI-patients and in 8% of NON-IMID-LTBI-subjects. Applying a logistic regression analysis, we found that IMID-LTBI patients had a higher probability (TB1 stimulation OR 3.32; TB2 stimulation OR 4.33) to have IFNγ results ≤0.7 IU/mL compared to NON-IMID-LTBI-subjects. Interestingly, IMID-treatment did not interfere with the distribution of IFNγ-values. Conclusions: These results indicate that IMID-LTBI-patients have a low IFN-γ response to QFT-P, a high proportion of results ranging in the grey zone and a distribution of IFNγ-values independent from the IMID-treatment. These results are important for the management of LTBI screening in IMID patients.

Characterization of QuantiFERON-TB-Plus results in latent tuberculosis infected patients with or without immune-mediated inflammatory diseases / Chiacchio, Teresa; Petruccioli, Elisa; Vanini, Valentina; Cuzzi, Gilda; Massafra, Umberto; Baldi, Gianpiero; Navarra, Assunta; Scrivo, Rossana; Mastroianni, Claudio; Sauzullo, Ilaria; Esposito, Carmela; Palmieri, Fabrizio; Cantini, Fabrizio; Goletti, Delia. - In: JOURNAL OF INFECTION. - ISSN 0163-4453. - 79:1(2019), pp. 15-23. [10.1016/j.jinf.2019.04.010]

Characterization of QuantiFERON-TB-Plus results in latent tuberculosis infected patients with or without immune-mediated inflammatory diseases

Scrivo, Rossana;Mastroianni, Claudio;Sauzullo, Ilaria;
2019

Abstract

Objectives: Screening for latent tuberculosis infection (LTBI) diagnosis is mandatory in patients with immune-mediated inflammatory diseases (IMID) requiring biologics. QuantiFERON-TB-Plus (QFT-P), an LTBI diagnostic test, measures IFN-γ after M. tuberculosis-stimulation in TB1 and TB2 tubes in which a “CD4” or a “CD4 and CD8” response is respectively elicited. Aim of this study is to compare the response to QFT-P of IMID-LTBI patients candidates to a new biological therapy vs LTBI-subjects without IMID. Methods: We prospectively enrolled 167 subjects: 61 IMID-LTBI and 106 NON-IMID-LTBI. Results: All subjects were mitogen-responders. IFN-γ production was significantly lower in IMID-LTBI-patients compared to NON-IMID-LTBI-subjects. We observed discordant TB1 and TB2 results in 6.5% of IMID-LTBI-patients and in 8% of NON-IMID-LTBI-subjects. Applying a logistic regression analysis, we found that IMID-LTBI patients had a higher probability (TB1 stimulation OR 3.32; TB2 stimulation OR 4.33) to have IFNγ results ≤0.7 IU/mL compared to NON-IMID-LTBI-subjects. Interestingly, IMID-treatment did not interfere with the distribution of IFNγ-values. Conclusions: These results indicate that IMID-LTBI-patients have a low IFN-γ response to QFT-P, a high proportion of results ranging in the grey zone and a distribution of IFNγ-values independent from the IMID-treatment. These results are important for the management of LTBI screening in IMID patients.
2019
Anti-TNFα; Biological therapy; IGRA; IMID; LTBI; QuantiFERON-TB-Plus; Tuberculosis; Microbiology (medical); Infectious Diseases
01 Pubblicazione su rivista::01a Articolo in rivista
Characterization of QuantiFERON-TB-Plus results in latent tuberculosis infected patients with or without immune-mediated inflammatory diseases / Chiacchio, Teresa; Petruccioli, Elisa; Vanini, Valentina; Cuzzi, Gilda; Massafra, Umberto; Baldi, Gianpiero; Navarra, Assunta; Scrivo, Rossana; Mastroianni, Claudio; Sauzullo, Ilaria; Esposito, Carmela; Palmieri, Fabrizio; Cantini, Fabrizio; Goletti, Delia. - In: JOURNAL OF INFECTION. - ISSN 0163-4453. - 79:1(2019), pp. 15-23. [10.1016/j.jinf.2019.04.010]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1300391
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