scholarly journals Comparison of Interferon-Gamma Release Assay and Tuberculin Skin Test for the Screening of Latent Tuberculosis in Inflammatory Bowel Disease Patients: Indian Scenario

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Alok Kumar Mantri ◽  
Priti Meena ◽  
Amarender Singh Puri ◽  
Ajay Kumar ◽  
Sanjeev Sachdeva ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Bowel Disease ◽  
Latent Tuberculosis ◽  
Interferon Gamma Release Assay ◽  
Control Subjects ◽  
Release Assay ◽  
Inflammatory Bowel

Background. In a country like India, where the prevalence of tuberculosis is very high, the role of screening tools for detection of latent tuberculosis infection (LTBI) like TST and IGRA is still unclear, especially in inflammatory bowel disease (IBD) patients. Our study is aimed at comparing the interferon-gamma release assay (IGRA) and tuberculin skin test (TST) to determine the prevalence of LTBI in IBD patients in the Indian subset of the population. Methods. It was a prospective observational analysis. A total of 257 participants were included in the study. Both TST and IGRA were performed in consecutive patients diagnosed with IBD (131 patients) and in 126 healthy individuals. Both tests were performed on the same day. LTBI diagnosis was considered if any one of TST or IGRA was found to be positive. Results. Out of 131 IBD patients, 121 patients had ulcerative colitis and 10 patients had Crohn’s disease. 29% of the IBD patients and 22% of the control subjects had LTBI. The study demonstrated concordance between TST and IGRA. Agreement test kappa value for IBD patients was 0.656 (CI 0.50-0.81), with a p value of <0.001, suggestive of a fair agreement. Mean IFN-γ release was lower in the immunosuppressed group as compared to non-immunosuppressed individuals ( 0.26 ± 0.17 vs. 0.45 ± 0.07 , p = 0.02 ). Cohen’s kappa coefficient values in IBD cases and control subjects were 0.66 and 0.79, respectively. TST was found to be negatively correlated to BMI. Conclusion. Agreement between TST and IGRA was fair in IBD patients. For LTBI screening in IBD patients, TST and IGRA are complementary methods.

Superiority of Interferon Gamma Assay Over Tuberculin Skin Test for Latent Tuberculosis in Inflammatory Bowel Disease Patients in Brazil

2019 ◽  
Vol 64 (7) ◽  
pp. 1916-1922 ◽  
Author(s):  
Renata F. Amorim ◽  
Eduardo R. C. Viegas ◽  
Antonio José V. Carneiro ◽  
Barbara C. Esberard ◽  
Evelyn S. Chinem ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Bowel Disease ◽  
Latent Tuberculosis ◽  
Inflammatory Bowel ◽  
Gamma Assay

Tuberculin Skin Test and Quantiferon in BCG Vaccinated, Immunosuppressed Patients with Moderate-to-Severe Inflammatory Bowel Disease

2015 ◽  
Vol 24 (4) ◽  
pp. 467-472 ◽  
Author(s):  
Zsuzsanna Kurti ◽  
Barbara Dorottya Lovasz ◽  
Krisztina Barbara Gecse ◽  
Anita Balint ◽  
Klaudia Farkas ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Risk Factor ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Latent Tuberculosis ◽  
Interferon Gamma Release Assay ◽  
Immunosuppressed Patients ◽  
Release Assay ◽  
Inflammatory Bowel

Background & Aims: There are few data available on the effect of immunomodulator/biological therapy on the accuracy of the tuberculin skin test (TST) and interferon-gamma release assay (IGRA) in BCG-vaccinated immunosuppressed patients with inflammatory bowel disease (IBD). Our aim was to define the accuracy, predictors and agreement of TST and IGRA in a BCG-vaccinated immunosuppressed referral IBD cohort. Methods: 166 consecutive moderate-to-severe IBD patients (122 Crohn’s disease, CD and 44 ulcerative colitis, UC) were enrolled in a prospective study from three centers. Patients were treated with immunosuppressives and/or biologicals. IGRA and TST were performed on the same day. Both in- and outpatient records were collected and comprehensively reviewed. Results: TST positivity rate was 23.5%, 21.1%,14.5% and 13.9% when cut-off values of 5, 10, 15 and 20mm were used. IGRA positivity rate was 8.4% with indeterminate result in 0.6%. Chest X-ray was suggestive of latent tuberculosis in 2 patients. Correlation between TST and IGRA was moderate (kappa: 0.39-0.41, p<0.001). In addition, a cut-off of 14 and 17mm for TST was defined to identify IGRA positivity in a ROC analysis (AUC: 0.76, p=0.03). TST and/or IGRA positivity was not influenced by medical therapy or disease phenotype. Importantly, smoking was identified as a risk factor for TST but not IGRA positivity (OR: 2.70-5.02, p<0.01, for TSTcut-offs=5-20mm). Conclusion: TST and IGRA tests are partly complimentary methods, and additional testing by TST (with a cut-off of >15mm) should be considered to identify patients at risk for latent TB. Accuracy is satisfactory in BCG-vaccinated, immunosuppressed IBD patients. Smoking is a risk factor for TST positivity.– . Abbreviations: AZA: azathioprine; BCG: Bacille Calmette-Guérin; CD: Crohn’s disease; CRP: C-reactive protein; HBI: Harvey–Bradshaw Index; IBD: inflammatory bowel diseases; IGRA: interferon-gamma release assay; IST: immunosuppressive therapy; LTB: latent tuberculosis; UC: ulcerative colitis; TB: tuberculosis; TNF: tumor necrosis factor; TST: tuberculin skin test/ Mantoux skin test

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