1. Serial interferon-gamma release assays for latent tuberculosis in dialysis patients with end stage renal disease in a Korean population.
- Author
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Seung Heon Lee, Hee Jin Kim, Seok Ju Park, Tae Hee Kim, So Jeong Park, Sun Woo Kang, Yeong Hoon Kim, Menzies, Dick, Lee, Seung Heon, Kim, Hee Jin, Park, Seok Ju, Kim, Tae Hee, Park, So Jeong, Kang, Sun Woo, and Kim, Yeong Hoon
- Subjects
TUBERCULOSIS complications ,TUBERCULOSIS diagnosis ,CHRONIC kidney failure complications ,ASIANS ,DEMOGRAPHY ,HEMODIALYSIS ,INTERFERONS ,LONGITUDINAL method ,PERITONEAL dialysis ,RESEARCH evaluation ,TUBERCULOSIS ,INTERFERON gamma release tests - Abstract
Background: 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 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.Methods: We 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.Results: Positive QFT-IT at the first and 2(nd) tests were 41.9 and 34.4 %, respectively. The concordance rate between baseline QFT-IT and 2(nd) QFT in 93 ESRD patients was excellent (90.3 %, kappa = 0.80, p < 0.001). Agreement between the first QFT-IT and 2(nd) 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].Conclusions: In 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. [ABSTRACT FROM AUTHOR]- Published
- 2015
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