Abstract
BackgroundSerial interferon-gamma-release-assay (IGRA) result can show variance due to within-subject variation and difference in host immune status, and may be affected by latent tuberculosis infection (LTBI) treatment. We aimed to know the changes in QFT-IT (QuantiFERON-TB Gold In-Tube) results measured at a 4 month interval in end stage renal disease patients and whether these changes were influenced by dialysis method or LTBI treatment.MethodsWe prospectively performed serial QFT-IT tests at 4 month interval in 93 end stage renal disease (ESRD) patients on HD (hemodialysis) or PD (peritoneal dialysis). LTBI treatment was given to 18 of 39 patients with initial positive QFT-IT result. Agreement between the two results was estimated for all 93 patients and reversion rates were estimated among the 39 patients with initial positive QFT-IT.ResultsPositive QFT-IT at the first and 2nd tests were 41.9 and 34.4 %, respectively. The concordance rate between baseline QFT-IT and 2nd QFT in 93 ESRD patients was excellent (90.3 %, kappa = 0.80, p < 0.001). Agreement between the first QFT-IT and 2nd QFT-IT in HD (95.3 %, kappa = 0.91, p < 0.001) was higher than in PD patients (86.0 %, kappa = 0.69, p < 0.001). Among all ESRD patients, the odds of reversion of QFT-IT was not different in those who were, or were not treated for LTBI [odds ratio = 2.3 (0.5–11.4), p = 0.43].ConclusionsIn a group of 93 dialyzed ESRD patients 8.6 % showed reversion of initial positive QFT to negative within 4 months. Reversion seemed not to be associated with LTBI treatment. Further study with larger numbers of patients is needed to investigate the variation of QFT-IT tests in dialyzed ESRD patients.
Highlights
Serial interferon-gamma-release-assay (IGRA) result can show variance due to within-subject variation and difference in host immune status, and may be affected by latent tuberculosis infection (LTBI) treatment
We prospectively evaluated QFT-IT tests on two occasions at a four month interval in dialyzed end stage renal disease (ESRD) patients, some of whom received LTBI treatment, to estimate the variation of the QFT-IT on repeated testing, and the effect of dialysis type and LTBI therapy
2nd QFT-IT test could not be performed for 57 ESRD patients (HD:22, Peritoneal dialysis (PD):35), because 6 patients (HD:2, PD:4) were in inpatient care for associated disease, 13 patients (HD:6, PD:7) were transferred out to other hospital, and 38 patients (HD:14, PD:24) refused to participate in further study
Summary
Serial interferon-gamma-release-assay (IGRA) result can show variance due to within-subject variation and difference in host immune status, and may be affected by latent tuberculosis infection (LTBI) treatment. ESRD patients as well as renal-transplant patients on immune suppressive agents who have LTBI have an increased risk for progressive active TB [6]. The annual incidence of active TB in South Korea where BCG vaccination is mandatory is intermediate (84/100,000) [7] and that of active TB in renal transplant patients is 0.5 %/year in South Korea [8]. It would be better to treat LTBI in dialyzed ESRD patients before transplantation, because prophylactic TB drug like rifampicin can lead to drug interaction with immune suppression drug on kidneytransplantation recipients [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
