PMID- 22863801
OWN - NLM
STAT- MEDLINE
DCOM- 20130117
LR  - 20121030
IS  - 1815-7920 (Electronic)
IS  - 1027-3719 (Linking)
VI  - 16
IP  - 10
DP  - 2012 Oct
TI  - Screening for latent tuberculosis in anti-TNF-alpha candidate patients in a high 
      tuberculosis incidence setting.
PG  - 1307-14
LID - 10.5588/ijtld.12.0111 [doi]
AB  - BACKGROUND: Screening for latent tuberculosis infection (LTBI) using a protocol 
      comprising chest X-ray and tuberculin skin test (TST) interpreted with medical 
      history, Sc1, reduces LTBI reactivation on treatment with anti-tumour necrosis 
      factor-alpha (anti-TNF-alpha). In the district of Seine-Saint-Denis, France, where 
      tuberculosis (TB) incidence ranges from 30 to >100/100 000 person-years, however, 
      Sc1 might be insensitive as a screening tool. We adopted another protocol, Sc2, 
      comprising Sc1 plus two additional tests: the QuantiFERON((R))-TB Gold In-Tube 
      (QFT-GIT) and chest computed tomography (CT). METHODS: We screened 123 
      consecutive patients with inflammatory rheumatic diseases (IRDs), candidates for 
      anti-TNF-alpha treatment, and evaluated the impact of Sc2 vs. Sc1 on the prescription 
      of prophylactic anti-tuberculosis treatment. RESULTS: Sc2 led to a diagnosis of 
      LTBI in 69 patients vs. 59 when using Sc1: eight were QFT-GIT-positive. Diagnosis 
      was based on CT findings in two patients. QFT-GIT had higher diagnostic accuracy 
      than TST, but no single diagnostic test could detect all patients at high risk 
      for LTBI reactivation (respectively 30.2% and 37.5% of patients positive with 
      only TST or QFT-GIT). CT detected TB sequelae in 3/46 rheumatoid arthritis 
      patients who were negative to all tests. CONCLUSIONS: Testing with both TST and 
      QFT-GIT seems the safest strategy for detecting LTBI in patients with IRD from 
      populations with high incidence of TB. Systematic screening with CT warrants 
      further evaluation.
FAU - Saidenberg-Kermanac'h, N
AU  - Saidenberg-Kermanac'h N
AD  - Department of Rheumatology, Avicenne Hospital, Assistance Publique-Hopitaux de 
      Paris, Bobigny, France. nathalie.saidenberg@avc.aphp.fr
FAU - Semerano, L
AU  - Semerano L
FAU - Naccache, J M
AU  - Naccache JM
FAU - Brauner, M
AU  - Brauner M
FAU - Falgarone, G
AU  - Falgarone G
FAU - Dumont-Fischer, D
AU  - Dumont-Fischer D
FAU - Guillot, X
AU  - Guillot X
FAU - Valeyre, D
AU  - Valeyre D
FAU - Boissier, M-C
AU  - Boissier MC
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20120803
PL  - France
TA  - Int J Tuberc Lung Dis
JT  - The international journal of tuberculosis and lung disease : the official journal 
      of the International Union against Tuberculosis and Lung Disease
JID - 9706389
RN  - 0 (Immunologic Factors)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Female
MH  - Follow-Up Studies
MH  - France/epidemiology
MH  - Humans
MH  - Immunologic Factors/*therapeutic use
MH  - Incidence
MH  - Latent Tuberculosis/diagnosis/drug therapy/*epidemiology
MH  - Male
MH  - Mass Screening/*methods
MH  - Middle Aged
MH  - Reproducibility of Results
MH  - Risk Factors
MH  - Tomography, X-Ray Computed
MH  - Tuberculin Test
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
EDAT- 2012/08/07 06:00
MHDA- 2013/01/18 06:00
CRDT- 2012/08/07 06:00
PHST- 2012/08/07 06:00 [entrez]
PHST- 2012/08/07 06:00 [pubmed]
PHST- 2013/01/18 06:00 [medline]
AID - ijtld120111 [pii]
AID - 10.5588/ijtld.12.0111 [doi]
PST - ppublish
SO  - Int J Tuberc Lung Dis. 2012 Oct;16(10):1307-14. doi: 10.5588/ijtld.12.0111. Epub 
      2012 Aug 3.