Risk Assessment of Tuberculosis in Immunocompromised Patients A TBNET Study

• Tipo: Artigo em Revista Científica Internacional
• Data: 2014

Autores

Sester, M (Autor) Outra; Van Leth, F (Autor) Outra; Bruchfeld, J (Autor) Outra; Bumbacea, D (Autor) Outra; Cirillo, DM (Autor) Outra; Dilektasli, AG (Autor) Outra; Dominguez, J (Autor) Outra; Duarte R (Autor) FMUP; Ernst, M (Autor) Outra; Eyuboglu, FO (Autor) Outra; Gerogianni, I (Autor) Outra; Girardi, E (Autor) Outra; Goletti, D (Autor) Outra; Janssens, JP (Autor) Outra; Julander, I (Autor) Outra; Lange, B (Autor) Outra; Latorre, I (Autor) Outra; Losi, M (Autor) Outra; Markova, R (Autor) Outra; Matteelli, A (Autor) Outra; Milburn, H (Autor) Outra; Ravn, P (Autor) Outra; Scholman, T (Autor) Outra; Soccal, PM (Autor) Outra; Straub, M (Autor) Outra; Wagner, D (Autor) Outra; Wolf, T (Autor) Outra; Yalcin, A (Autor) Outra; Lange, C (Autor) Outra; TBNET, (Autor) Outra

Revista

Título: American Journal of Respiratory and Critical Care Medicine

Vol. 190

Páginas: 1168-1176

ISSN: 1073-449X

Editora: American Thoracic Society

Indexação

ISI Web of Knowledge - 158 Citações

Scopus - 170 Citações

Outras Informações

ID Authenticus: P-00A-1SB

DOI: 10.1164/rccm.201405-0967oc

Abstract (EN): Rationale: In the absence of active tuberculosis, a positive tuberculin skin test (TST) or interferon-gamma release assay (IGRA) result defines latent infection with Mycobacterium tuberculosis, although test results may vary depending on immunodeficiency. Objectives: This study compared the performance of TST and IGRAs in five different groups of immunocompromised patients, and evaluated their ability to identify those at risk for development of tuberculosis. Methods: Immunocompromised patients with HIV infection, chronic renal failure, rheumatoid arthritis, solid-organ or stem-cell transplantation, and healthy control subjects were evaluated head-to-head by the TST, QuantiFERON-TB-Gold in-tube test (ELISA), and T-SPOT. TB test (enzyme-linked immunospot) at 17 centers in 11 European countries. Development of tuberculosis was assessed during follow-up. Measurements and Main Results: Frequencies of positive test results varied from 8.7 to 15.9% in HIV infection (n = 768), 25.3 to 30.6% in chronic renal failure (n = 270), 25.0% to 37.2% in rheumatoid arthritis (n = 199), 9.0 to 20.0% in solid-organ transplant recipients (n = 197), 0% to 5.8% in stem-cell transplant recipients (n = 103), and 11.2 to 15.2% in immunocompetent control subjects (n = 211). Eleven patients (10 with HIV infection and one solid-organ transplant recipient) developed tuberculosis during a median follow-up of 1.8 (interquartile range, 0.2-3.0) years. Six of the 11 patients had a negative or indeterminate test result in all three tests at the time of screening. Tuberculosis incidence was generally low, but higher in HIV-infected individuals with a positive TST (3.25 cases per 100 person-years) than with a positive ELISA (1.31 cases per 100 person-years) or enzyme-linked immunospot result (1.78 cases per 100 person-years). No cases of tuberculosis occurred in patients who received preventive chemotherapy. Conclusions: Among immunocompromised patients evaluated in this study, progression toward tuberculosis was highest in HIV-infected individuals and was poorly predicted by TST or IGRAs.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 9