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- Title
Comparison of Interferon-Gamma Release Assay Versus Tuberculin Skin Test for Tuberculosis Screening in Inflammatory Bowel Disease.
- Authors
Schoepfer, Alain M.; Flogerzi, Beatrice; Fallegger, Silvia; Schaffer, Thomas; Mueller, Stefan; Nicod, Laurent; Seibold, Frank
- Abstract
OBJECTIVES: Reactivation of latent tuberculosis (TB) in inflammatory bowel disease (IBD) patients treated with antitumor necrosis factor-alpha medication is a serious problem. Currently, TB screening includes chest x-rays and a tuberculin skin test (TST). The interferon-gamma release assay (IGRA) QuantiFERON-TB Gold In-Tube (QFT-G-IT) shows better specificity for diagnosing TB than the skin test. This study evaluates the two test methods among IBD patients. METHODS: Both TST and IGRA were performed on 212 subjects (114 Crohn's disease, 44 ulcerative colitis, 10 indeterminate colitis, 44 controls). RESULTS: Eighty-one percent of IBD patients were under immunosuppressive therapy; 71% of all subjects were vaccinated with Bacille Calmette Guérin; 18% of IBD patients and 43% of controls tested positive with the skin test ( P < 0.0001). Vaccinated controls tested positive more often with the skin test (52%) than did vaccinated IBD patients (23%) ( P= 0.011). Significantly fewer immunosuppressed patients tested positive with the skin test than did patients not receiving therapy ( P= 0.007); 8% of patients tested positive with the QFT-G-IT test (14/168) compared to 9% (4/44) of controls. Test agreement was significantly higher in the controls ( P= 0.044) compared to the IBD group. CONCLUSIONS: Agreement between the two test methods is poor in IBD patients. In contrast to the QFT-G-IT test, the TST is negatively influenced by immunosuppressive medication and vaccination status, and should thus be replaced by the IGRA for TB screening in immunosuppressed patients having IBD.
- Subjects
INTERFERONS; TUBERCULIN test; SKIN tests; TUBERCULOSIS diagnosis; INFLAMMATORY bowel diseases
- Publication
American Journal of Gastroenterology (Springer Nature), 2008, Vol 103, Issue 11, p2799
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.2008.02050.x