The usefulness of quantitative interferon-gamma releasing assay response for predicting active tuberculosis in kidney transplant recipients: A quasi-experimental study - 06/08/20
, Joo Hee Jung b, Min Jae Kim a, Hyosang Kim c, Sung Shin b, Yong Pil Chong a, Young-Hoon Kim b, Sang-Oh Lee a, Sang-Ho Choi a, Yang Soo Kim a, Jun Hee Woo a, Su-Kil Park c, Duck Jong Han bHighlights |
• | We evaluated the effectiveness of quantitative IGRA-based INH treatment for TB in KT. |
• | The number needed to treat for IGRA-based INH treatment was 31. |
• | The number needed to treat based positive IGRA titer 2.96 IU/mL was 16. |
• | IGRA-based INH treatment is effective to prevent the TB development in KT recipients. |
• | Quantitative IGRA results before KT are useful to predict the TB development after KT. |
Abstract |
Objectives |
We evaluated the effectiveness of IGRA-based isoniazid (INH) treatment with the diagnostic value of quantitative IGRA titer for post-transplant tuberculosis (TB) in kidney transplant (KT) recipients.
Methods |
All adult KT recipients were enrolled from January 2014 to December 2017. The development of TB after KT was observed, stratified by quantitative IGRA results as well as by IGRA results with/without INH treatment.
Results |
Of 1150 KT recipients, 322 (28%) revealed positive IGRA results (≥0.35 IU/mL) and 12 (1.0%) developed TB. Seven (3.2%) of 217 patients with positive IGRA without INH developed TB, whereas none of 105 patients with positive IGRA with INH developed TB (rate difference −1616 per 100,000 person-years, P = 0.016) and 5 (0.6%) of 828 patients with negative or indeterminate IGRA developed TB (rate difference −1388 per 100,000 person-years, P<0.001). Among the 217 positive IGRA patients without INH, 6 (6.4%) of 94 patients who had positive IGRA titer>2.96 IU/mL developed TB, whereas one (0.8%) of 123 patients who had positive IGRA titer≤2.96 IU/mL developed TB (rate difference 2964 per 100,000 person-years, P = 0.017).
Conclusions |
IGRA-based INH treatment with risk stratification by quantitative IGRA results appears to be effective to prevent the development of TB in KT recipients.
Le texte complet de cet article est disponible en PDF.Keywords : Tuberculosis, Interferon-gamma releasing assay, Tuberculin skin test, Isoniazid, Kidney-transplantation
Plan
Vol 81 - N° 3
P. 403-410 - septembre 2020 Retour au numéro
Article précédent
- Risk of subsequent ischemic stroke in patients with nontyphoidal salmonellosis: A nationwide population-based cohort study
- Renin Chang, James Cheng-Chung Wei, Mei-Chen Lin, Yao-Min Hung, Chih-Hsin Hung
- SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes
- N.S.N. Graham, C. Junghans, R. Downes, C. Sendall, H. Lai, A. McKirdy, P. Elliott, R. Howard, D. Wingfield, M. Priestman, M. Ciechonska, L. Cameron, M. Storch, M.A. Crone, P.S. Freemont, P. Randell, R. McLaren, N. Lang, S. Ladhani, F. Sanderson, D.J. Sharp
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?