scholarly journals Psoriatic Disease and Tuberculosis Nowadays

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Nicola Balato ◽  
Luisa Di Costanzo ◽  
Fabio Ayala ◽  
Anna Balato ◽  
Alessandro Sanduzzi ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Type Ii Diabetes Mellitus ◽  
Tuberculosis Infection ◽  
Joint Disease ◽  
Necrosis Factor Alpha ◽  
Traditional Concept ◽  
Increased Risk ◽  
History Of ◽  
Factor Alpha

Psoriasis is a chronic, relapsing and remitting inflammatory skin and joint disease that has a prevalence of 2-3% in the world’s population, whereas of 1–2% in Europe. The traditional concept of psoriasis as the “healthy people’s” disease has been recently revised because of ever-increasing reports of associations with various pathological conditions (hypertension, Crohn’s disease, type II diabetes mellitus, obesity, dyslipidemia, metabolic syndrome, infectious conditions). Particularly, advances in psoriasis therapies have introduced biologic agents. All the tumor necrosis factor-alpha inhibitors are associated with an increased risk of developing active disease in patients with latent tuberculosis infection, because of TNF-αkey role againstMycobacterium tuberculosis. For this reason, exclusion of active tuberculosis and treatment of latent tuberculosis infection are clinical imperatives prior to starting this therapy. Moreover active surveillance for a history of untreated or partially treated tuberculosis or latent form has already been shown to be effective in reducing the number of incident tuberculosis cases.

scholarly journals 754. Prevalence of Latent Tuberculosis Infection Among Healthcare Workers at a Tertiary Care University Hospital

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S271-S271
Author(s):  
Eun Ju Choo ◽  
Se Yoon Park
Keyword(s):  
Risk Factors ◽  
Healthcare Workers ◽  
Latent Tuberculosis Infection ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
University Hospital ◽  
Increased Risk ◽  
High Prevalence ◽  
Univariate Analyses

Abstract Background We investigated the prevalence of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) and analyzed its risk factors in a tertiary care university hospital in South Korea in a population with intermediate tuberculosis (TB) burden. Methods A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant. QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay and chest radiography were performed to investigate the rate of LTBI. Results A total of 1,429 participants, 213 (14.9%) doctors and 988 (69.1%) nurses and 228 (16.0%) others were enrolled. The mean age of the subjects was 33.0 years old, and 1,175 (82.2%) were female. Of the participants, 94.5% had received BCG vaccine. QFT-GIT assays were positive for 156 subjects (10.9%). Of the 213 doctors, 28 (13.1%) were positive by QFT-GIT, and among the 988 nurses, 94 (9.5%) had positive QFT-GIT results. Experience of working in hospital was significantly associated with positive LTBI test results by QFT-GIT assay. Gender and duration of employment as an HCW were significantly associated with having a positive QFT-GIT result in univariate analyses. In multivariate analyses, duration of employment as an HCW (>15 years) (odds ratio, 1.98; 95% confidence interval, 1.14–3.43) was independently associated with increased risk of a positive QFT-GIT result. Conclusion A high prevalence of LTBI was found among our HCWs. Considering the association between the experience of working in hospital and high risk of LTBI. The risk for tuberculosis infection among HCWs was higher than general population, which suggests that stricter preventive strategies against nosocomial tuberculosis infection should be implemented. Disclosures All authors: No reported disclosures.

scholarly journals Comparative Evaluation of QuantiFERON-TB Gold In-Tube and QuantiFERON-TB Gold Plus in Diagnosis of Latent Tuberculosis Infection in Immunocompromised Patients

2018 ◽  
Vol 56 (11) ◽  
Author(s):  
Mi Ra Ryu ◽  
Min-Seung Park ◽  
Eun Hye Cho ◽  
Chul Won Jung ◽  
Kihyun Kim ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Organ Transplant ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Clinical Approach ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
Necrosis Factor Alpha ◽  
Hematopoietic Stem ◽  
The Difference

ABSTRACT QuantiFERON-TB Gold Plus (QFT-Plus) is a new-generation QuantiFERON-TB Gold In-Tube (QFT-GIT) assay which has two antigen-coated tubes called TB1, which contains long peptides derived from ESAT-6 and CFP-10, and TB2, which contains the same components as TB1 and additional short peptides which potentially stimulate CD8+ T cells through the presentation of major histocompatibility complex class I. This is the first study to compare QFT-Plus and QFT-GIT for use in the diagnosis of latent tuberculosis infection (LTBI) among immunocompromised patients in the Republic of Korea. Among 317 consecutive patients who underwent screening for LTBI before solid organ or hematopoietic stem cell transplantation and tumor necrosis factor alpha inhibitor treatment, LTBI was identified in 92 (29.0%) and 88 (27.8%) patients by QFT-GIT and QFT-Plus, respectively. The rate of concordance between QFT-GIT and QFT-Plus was 93.7% (κ value, 0.860), and the indeterminate rate (3.2%) was similar between QFT-GIT and QFT-Plus. Of 20 (6.3%) samples with discordant results, 11 (55.0%) and 7 (35.0%) were positive by QFT-GIT alone and QFT-Plus alone, respectively, and 2 (15.0%) were indeterminate by each assay. The interferon gamma level in samples with discordant results ranged from 0.39 to 1.10 IU/ml, except for one sample, in which the gamma interferon level was 2.97 IU/ml only in TB2. Conclusively, there was a high degree of agreement between the results of QFT-GIT and QFT-Plus for the screening of immunocompromised patients for LTBI. The reactivity in TB2 contributed substantially to the difference between QFT-GIT and QFT-Plus, particularly in solid organ transplant candidates. The significance of the discrete responses in TB1 and TB2 of QFT-Plus needs to be explored further by means of an immunological and clinical approach in different patient groups and clinical settings.

scholarly journals Prolonged paradoxical reaction to antituberculous treatment after discontinuation of TNF-alpha- blocker therapy with adalimumab. Rare clinical documentation

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Roger Fei Falkenstern-Ge ◽  
Kim Husemann ◽  
Martin Kohlhäufl
Keyword(s):  
Inflammatory Diseases ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Paradoxical Reaction ◽  
Necrosis Factor Alpha ◽  
Blocker Therapy ◽  
Antituberculous Treatment ◽  
Tnf Antagonist ◽  
Factor Alpha ◽  
Tuberculosis Therapy

AbstractIn the past decades, tumor necrosis factor alpha (TNF-a) antagonist has been a milestone in the treatment of many chronic inflammatory diseases. TNF antagonist can increase patients´ susceptibility to many different kinds of infections especially those requiring granuloma formations despite regular performance of Screening for latent tuberculosis infection (LTBI). We report 2 cases of patients who developed tuberculosis under treatment with adalimumab, which was discontinued after the diagnosis of tuberculosis. During the tuberculosis therapy they unexpectedly developed a prolonged paradoxical reaction. In both cases we were only able to manage the progress of the paradoxical reaction through high steroid doses. Patients undergoing therapy with TNF- alphablocker are prone to develop tuberculosis infection, which could in turn lead to severe prolonged paradoxical reaction during anti-tuberculous treatment. An increased steroid dose may be required and is sometimes necessary

scholarly journals MANAGEMENT OF A PATIENT WITH ANKYLOSING SPONDYLITIS TYPE SPONDYLOARTHRITIS AND LATENT TUBERCULOSIS INFECTION

2021 ◽  
Vol 2 (1) ◽  
pp. 19
Author(s):  
Nadhya Allia ◽  
Lita Diah Rahmawati
Keyword(s):  
Ankylosing Spondylitis ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Prophylactic Therapy ◽  
Dmard Therapy ◽  
Physical Laboratory ◽  
Increased Risk ◽  
Rheumatic Patients ◽  
Disease Modifying Antirheumatic Drug

Ankylosing spondylitis (AS) is one of the most common types of spondylarthritis (SpA) and Disease-Modifying Antirheumatic Drug (DMARD) is one of the modalities for treating the disease. An increased risk of latent tuberculosis infection (LTBI) reactivation in rheumatic patients receiving DMARD has been reported. Management of patients with rheumatic diseases who are also infected with LTBI needs to be understood in order not tobecome active TB. We reported a case of a 57-year-old man with AS. Patient was planned to be treated with DMARD so that hepatitis and TB screening performed. It was discovered that this patient had LTBI. The prophylactic therapy for TB was given. DMARD therapy started 1 month after TB prophylactic therapy was given. For monitoring the disease progression,anamnesis, physical, laboratory, and radiology examination performed regularly.

scholarly journals Screening Optimization of Latent Tuberculosis Infection in Rheumatoid Arthritis Patients

Arthritis ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Bella Mehta ◽  
Ekaterini Zapantis ◽  
Olga Petryna ◽  
Petros Efthimiou
Keyword(s):  
Rheumatoid Arthritis ◽  
Inner City ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Foreign Born ◽  
Initial Screening ◽  
Early Screening ◽  
Prompt Treatment ◽  
Increased Risk

Objective. Rheumatoid arthritis (RA) patients are at increased risk of latent tuberculosis infection (LTBI) but there are no clear guidelines for LTBI screening with Tuberculin Skin Test (TST) or Quantiferon TB Gold testing (QFT-G). Methods. A retrospective study was conducted in a high risk, largely foreign-born, inner city, RA population. After screening 280 RA patients, 134 patients who had both TST and QFT-G testing performed during their initial evaluation were included. Results. Out of 132 RA patients included in our analysis, 50 (37.8%) patients were diagnosed with LTBI with either positive TST 42 (31.8%) or QFT-G 23 (17.4%). 15 (11.4%) were positive and 82 (62.1%) were negative for both tests. The agreement between TST and QFT-G was 73.5% (Kappa 0.305, CI = 95% 0.147–0.463, p=0.081).  Conclusions. There was low-moderate agreement (κ=0.305) between TST and QFT-G. In the absence of clearly defined gold standard and limitations associated with both tests, we propose early screening with both tests for patients who need prompt treatment with BRMs. Patients who are not immediate candidates for BRM treatment may be safely and cost effectively screened with a two-step process: initial screening with TST and if negative, IGRA testing. Patients positive for either test should be promptly treated.

scholarly journals Latent Tuberculosis Infection and Subclinical Coronary Atherosclerosis in Peru and Uganda

2021 ◽  
Author(s):  
Moises A Huaman ◽  
Carlo N De Cecco ◽  
Marcio S Bittencourt ◽  
Eduardo Ticona ◽  
Cissy Kityo ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Coronary Atherosclerosis ◽  
Adjusted Odds Ratio ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Increased Risk ◽  
Ascvd Risk

Abstract Background Tuberculosis has been linked to an increased risk of atherosclerotic cardiovascular disease (ASCVD). We assessed whether latent tuberculosis infection (LTBI) is associated with subclinical coronary atherosclerosis in two TB-prevalent areas. Methods We analyzed cross-sectional data from studies conducted in Lima, Peru, and Kampala, Uganda. Individuals ≥40 years old were included. We excluded persons with known history of ASCVD events or active TB. Participants underwent QuantiFERON®-TB (QFT) testing to define LTBI, and computed tomography angiography to examine coronary atherosclerosis. A Coronary Artery Disease-Reporting Data System (CAD-RADS) score ≥3 defined obstructive CAD (plaque causing ≥50% stenosis). Results 113 persons with LTBI and 91 persons without LTBI were included. There were no significant differences between LTBI and non-LTBI participants in terms of age (median [interquartile range]; 56 [51–62] vs. 55 [49–64], p=0.829), male sex (38% vs. 42%; p=0.519), or 10-year ASCVD risk scores (7.1 [3.2–11.7] vs. 6.1 [2.8–10.8]; p=0.533). CAD prevalence (any plaque) was similar between groups (29% vs. 24%; p=0.421). Obstructive CAD was present in 9% of LTBI and 3% of non-LTBI individuals; p=0.095. LTBI was associated with obstructive CAD after adjusting for ASCVD risk score, HIV status, and study site (adjusted odds ratio, 4.96, 95% CI 1.05–23.44; p=0.043). Quantitative QFT TB antigen minus nil interferon-gamma responses were associated with obstructive CAD (adjusted odds ratio, 1.2, 95% CI 1.03–1.41; p=0.022). Conclusions LTBI was independently associated with an increased likelihood of subclinical obstructive CAD. Our data indicates that LTBI is a non-traditional correlate of ASCVD risk.

Incidence and Risk Factors Associated with Latent Tuberculosis Infection and Pulmonary Tuberculosis among People Deprived of Liberty in Colombian Prisons

2021 ◽  
Author(s):  
Mariana Herrera ◽  
Yoav Keynan ◽  
Lucelly López ◽  
Diana Marín ◽  
Luisa Arroyave ◽  
...  
Keyword(s):  
High Risk ◽  
Incidence Rate ◽  
Respiratory Symptoms ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Incidence Rates ◽  
Tuberculosis Infection ◽  
Current Cigarette Smoking ◽  
Factors Associated ◽  
Increased Risk

People deprived of liberty (PDL) are at high risk of acquiring Mycobacterium tuberculosis infection (latent tuberculosis infection [LTBI]) and progressing to active tuberculosis (TB). We sought to determine the incidence rates and factors associated with LTBI and active TB in Colombian prisons. Using information of four cohort studies, we included 240 PDL with two-step tuberculin skin test (TST) negative and followed them to evaluate TST conversion, as well as, 2,134 PDL that were investigated to rule out active TB (1,305 among people with lower respiratory symptoms of any duration, and 829 among people without respiratory symptoms and screened for LTBI). Latent tuberculosis infection incidence rate was 2,402.88 cases per 100,000 person-months (95% CI 1,364.62–4,231.10) in PDL with short incarceration at baseline, and 419.66 cases per 100,000 person-months (95% CI 225.80–779.95) in individuals with long incarceration at baseline (who were enrolled for the follow after at least 1 year of incarceration). The TB incidence rate among PDL with lower respiratory symptoms was 146.53 cases/100,000 person-months, and among PDL without respiratory symptoms screened for LTBI the incidence rate was 19.49 cases/100,000 person-months. History of Bacillus Calmette-Guerin vaccination decreased the risk of acquiring LTBI among PDL who were recently incarcerated. Female sex, smoked drugs, and current cigarette smoking were associated with an increased risk of developing active TB. This study shows that PDL have high risk for LTBI and active TB. It is important to perform LTBI testing at admission to prison, as well as regular follow-up to control TB in prisons.

scholarly journals Risk of Occupational Latent Tuberculosis Infection among Health Personnel Measured by Interferon-Gamma Release Assays in Low Incidence Countries—A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (2) ◽  
pp. 581 ◽  
Author(s):  
Claudia Peters ◽  
Agnessa Kozak ◽  
Albert Nienhaus ◽  
Anja Schablon
Keyword(s):  
Systematic Review ◽  
Occupational Exposure ◽  
Latent Tuberculosis Infection ◽  
Meta Analysis ◽  
Latent Tuberculosis ◽  
Occupational Risk ◽  
Tuberculosis Infection ◽  
Mediterranean Countries ◽  
Increased Risk ◽  
Low Incidence

Healthcare workers (HCWs) have increased risk for latent tuberculosis infection (LTBI) and tuberculosis (TB) disease due to their occupational exposure. For some years now, interferon-γ release assays (IGRAs) have replaced the tuberculin skin test for the diagnosis of LTBI in many countries. This review examined the occupational risk of LTBI in HCWs with IGRA testing in low incidence countries. A systematic review and meta-analysis of studies from 2005 onwards provide data regarding the prevalence of LTBI in HCWs. In addition, the pooled effect estimates were calculated for individual regions and occupational groups. 57 studies with 31,431 HCWs from four regions and a total of 25 countries were analysed. The prevalence of LTBI varied from 0.9 to 85.5%. The pooled estimation found the lowest prevalence of LTBI for North American and West Pacific countries (<5%), and the highest prevalence for Eastern Mediterranean countries (19.4%). An increased risk for LTBI was found only for administrative employees. Studies on the occupational risk of LTBI continue to show increased prevalence of HCWs, even in low-incidence countries. Good quality studies will continue to be needed to describe occupational exposure.

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