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

A new interesting article has been published in J Infect. 2019 Jul;79(1):15-23. doi: 10.1016/j.jinf.2019.04.010. Epub 2019 Apr 11. and titled:

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

Authors of this article are:

Chiacchio T, Petruccioli E, Vanini V, Cuzzi G, Massafra U, Baldi G, Navarra A, Scrivo R, Mastroianni C, Sauzullo I, Esposito C, Palmieri F, Cantini F, Goletti D.

A summary of the article is shown below:

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.Copyright © 2019. Published by Elsevier Ltd.

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This article is a good source of information and a good way to become familiar with topics such as: Anti-TNFα;Biological therapy;IGRA;IMID;LTBI;QuantiFERON-TB-Plus;Tuberculosis.

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