PMID- 30009853
OWN - NLM
STAT- MEDLINE
DCOM- 20200313
LR  - 20200313
IS  - 1532-2742 (Electronic)
IS  - 0163-4453 (Linking)
VI  - 78
IP  - 1
DP  - 2019 Jan
TI  - Interferon-gamma release assay for tuberculosis screening of solid-organ 
      transplant recipients is cost-effective.
PG  - 58-65
LID - S0163-4453(18)30215-9 [pii]
LID - 10.1016/j.jinf.2018.07.003 [doi]
AB  - OBJECTIVES: Tuberculosis (TB) is a serious infectious disease with high mortality 
      for solid-organ transplantation. Preventive therapy of latent tuberculosis 
      infection (LTBI) has been considered to reduce TB risk and improve outcomes of 
      transplantation. The aim of this study was to evaluate the cost-effectiveness of 
      the interferon-gamma release assays (IGRAs); QuantiFERON((R))-TB Gold in-Tube (QFT) 
      and T-SPOT((R)).TB (TSPOT)), for kidney, liver and lung transplant recipients in 
      low TB incidence countries. METHODS: Decision trees and Markov models were 
      developed for four strategies; QFT, TSPOT, the tuberculin skin test (TST) and no 
      screening. Targeted populations were hypothetical cohorts of kidney, liver and 
      lung transplant recipients aged 40 years using a societal perspective on a 
      lifetime horizon. Per-person costs, effectiveness and incremental cost 
      effectiveness ratios were calculated and compared. RESULTS: QFT was the most 
      cost-effective (Kidney; US$ 5679, 3.026 QALYs, Liver; US$ 5914, 2.365 QALYs, 
      Lung; US$ 6092, 3.761 QALYs). No screening was the least effective. 
      Cost-effectiveness was not sensitive to BCG vaccination rate, and the costs of 
      screening tests and treatment. CONCLUSIONS: TB screening using IGRA with 
      individualized TB risk assessment and follow-up monitoring of drug toxicity 
      during LTBI treatment is recommended for solid organ transplantation, on the 
      basis of the benefits and cost-effectiveness.
CI  - Copyright (c) 2018. Published by Elsevier Ltd.
FAU - Kowada, A
AU  - Kowada A
AD  - General Affairs Department, Ota City Office, Tokyo, Japan. Electronic address: 
      kowada-a7450@city.ota.tokyo.jp.
LA  - eng
PT  - Journal Article
DEP - 20180724
PL  - England
TA  - J Infect
JT  - The Journal of infection
JID - 7908424
SB  - IM
MH  - Adult
MH  - *Cost-Benefit Analysis
MH  - Decision Trees
MH  - Humans
MH  - Incidence
MH  - Interferon-gamma Release Tests/*economics
MH  - Latent Tuberculosis/diagnosis
MH  - Markov Chains
MH  - Organ Transplantation/adverse effects
MH  - Quality-Adjusted Life Years
MH  - *Transplant Recipients
MH  - Tuberculin Test/*economics
MH  - Tuberculosis/*diagnosis
OTO - NOTNLM
OT  - Economic analysis
OT  - IGRA
OT  - Isoniazid
OT  - Latent tuberculosis infection
OT  - Prevention
OT  - Transplantation
EDAT- 2018/07/17 06:00
MHDA- 2020/03/14 06:00
CRDT- 2018/07/17 06:00
PHST- 2018/01/06 00:00 [received]
PHST- 2018/05/12 00:00 [revised]
PHST- 2018/07/06 00:00 [accepted]
PHST- 2018/07/17 06:00 [pubmed]
PHST- 2020/03/14 06:00 [medline]
PHST- 2018/07/17 06:00 [entrez]
AID - S0163-4453(18)30215-9 [pii]
AID - 10.1016/j.jinf.2018.07.003 [doi]
PST - ppublish
SO  - J Infect. 2019 Jan;78(1):58-65. doi: 10.1016/j.jinf.2018.07.003. Epub 2018 Jul 
      24.