PMID- 19164327
OWN - NLM
STAT- MEDLINE
DCOM- 20090825
LR  - 20090521
IS  - 1460-2385 (Electronic)
IS  - 0931-0509 (Linking)
VI  - 24
IP  - 6
DP  - 2009 Jun
TI  - Interferon-gamma release assays versus tuberculin skin testing for detection of 
      latent tuberculosis in chronic haemodialysis patients.
PG  - 1952-6
LID - 10.1093/ndt/gfn748 [doi]
AB  - BACKGROUND: End stage renal disease increases the risk of reactivating latent 
      tuberculosis (LTBI). Interferon-gamma release assays (IGRA) are an alternative to 
      the tuberculin skin test (TST) for detecting LTBI. METHODS: Sixty-two 
      hemodialysis patients (46 male, 16 female, aged 65 +/- 15 years) from 3 
      hemodialysis facilities in the Geneva area were submitted to a TST, 2 IGRA 
      (T-SPOT.TB and QuantiFERON Gold in tube: QFT), a chest radiography, and a 
      questionnaire to record social status, country of birth, history of prior TST, 
      tuberculosis (TB), BCG (Bacillus of Calmette-Guerin vaccine), and any cause of 
      immuno-suppression. LTBI was defined as prior "at risk" contact with a case of 
      contagious TB and/or a chest X-ray suggestive of prior TB infection. RESULTS: 
      Positivity rate was 19% for TST, 21% for QFT and 29% for T-SPOT-TB; 8% of QFT and 
      11% of T-SPOT-TB were indeterminate. Agreement between IGRA was fair (kappa = 
      0.60). After adjusting for age and BCG, OR (Odds Ratio) of having a positive QFT 
      was 4.6-fold (p = 0.029) higher in patients with LTBI vs. those without LTBI. In 
      contrast, no association was found between LTBI and having a positive T-SPOT.TB 
      or a positive TST. As expected, there was a strong association between prior BCG 
      vaccination and having a positive TST (OR 5.3, p = 0.017). QFT was the only test 
      with a significant OR of having LTBI (adjusted OR: 4.4; 95%CI: 1.1 - 17.6; p = 
      0.034). Among 5 patients with definite prior TB, TST and T-SPOT.TB were positive 
      in 1 and QFT, in 2. CONCLUSIONS: In this population, QFT was superior to TST for 
      detecting LTBI, but both IGRAs and TST have important limitations, and are 
      unreliable for screening for LTBI.
FAU - Triverio, Pierre-Alain
AU  - Triverio PA
AD  - Division of Nephrology, Geneva University Hospital, 1211 Geneva 14, Switzerland.
FAU - Bridevaux, Pierre-Olivier
AU  - Bridevaux PO
FAU - Roux-Lombard, Pascale
AU  - Roux-Lombard P
FAU - Niksic, Laurent
AU  - Niksic L
FAU - Rochat, Thierry
AU  - Rochat T
FAU - Martin, Pierre-Yves
AU  - Martin PY
FAU - Saudan, Patrick
AU  - Saudan P
FAU - Janssens, Jean-Paul
AU  - Janssens JP
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20090122
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 82115-62-6 (Interferon-gamma)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Interferon-gamma/*blood
MH  - Kidney Failure, Chronic/*complications/immunology/*therapy
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - *Renal Dialysis
MH  - *Tuberculin Test
MH  - Tuberculosis, Pulmonary/*diagnosis/*etiology/immunology
EDAT- 2009/01/24 09:00
MHDA- 2009/08/26 09:00
CRDT- 2009/01/24 09:00
PHST- 2009/01/24 09:00 [entrez]
PHST- 2009/01/24 09:00 [pubmed]
PHST- 2009/08/26 09:00 [medline]
AID - gfn748 [pii]
AID - 10.1093/ndt/gfn748 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2009 Jun;24(6):1952-6. doi: 10.1093/ndt/gfn748. Epub 
      2009 Jan 22.