APA
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Sester, M., van Leth, F., Bruchfeld, J., Bumbăcea, D., Cirillo, D., Dilektaşlı, A., … Lange, C. (2014). Risk assessment of tuberculosis in immunocompromised patients. A TBNET study. American Journal of Respiratory and Critical Care Medicine.
Chicago/Turabian
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Sester, M., F. van Leth, J. Bruchfeld, D. Bumbăcea, D. Cirillo, A. Dilektaşlı, J. Domínguez, et al. “Risk Assessment of Tuberculosis in Immunocompromised Patients. A TBNET Study.” American Journal of Respiratory and Critical Care Medicine (2014).
MLA
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Sester, M., et al. “Risk Assessment of Tuberculosis in Immunocompromised Patients. A TBNET Study.” American Journal of Respiratory and Critical Care Medicine, 2014.
BibTeX Click to copy
@article{m2014a,
title = {Risk assessment of tuberculosis in immunocompromised patients. A TBNET study.},
year = {2014},
journal = {American Journal of Respiratory and Critical Care Medicine},
author = {Sester, M. and van Leth, F. and Bruchfeld, J. and Bumbăcea, D. and Cirillo, D. and Dilektaşlı, A. and Domínguez, J. and Duarte, R. and Ernst, M. and Eyuboglu, F. and Gerogianni, I. and Girardi, E. and Goletti, D. and Janssens, J. and Julander, I. and Lange, B. and Latorre, I. and Losi, M. and Markova, R. and Matteelli, A. and Milburn, H. and Ravn, P. and Scholman, T. and Soccal, P. and Straub, M. and Wagner, D. and Wolf, T. and Yalçın, A. and Lange, C.}
}
RATIONALE In the absence of active tuberculosis, a positive tuberculin skin test (TST) or interferon-γ 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. Clinical trial registered with www.clinicaltrials.gov (NCT 00707317).