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Chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients

BACKGROUND: A study of latent tuberculosis infection (LTBI) burden by chest roentgenography (CXR) with reference to interferon-gamma release assay (IGRA) is still lacking in rheumatic patients of an intermediate tuberculosis burden area. METHODS: We retrospectively reviewed clinical data of patients...

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Autores principales: Wang, Ping-Huai, Lin, Chou-Han, Chang, Ting-Hui, Wu, Chien-Sheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7461250/
https://www.ncbi.nlm.nih.gov/pubmed/32867745
http://dx.doi.org/10.1186/s12890-020-01274-9
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author Wang, Ping-Huai
Lin, Chou-Han
Chang, Ting-Hui
Wu, Chien-Sheng
author_facet Wang, Ping-Huai
Lin, Chou-Han
Chang, Ting-Hui
Wu, Chien-Sheng
author_sort Wang, Ping-Huai
collection PubMed
description BACKGROUND: A study of latent tuberculosis infection (LTBI) burden by chest roentgenography (CXR) with reference to interferon-gamma release assay (IGRA) is still lacking in rheumatic patients of an intermediate tuberculosis burden area. METHODS: We retrospectively reviewed clinical data of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), or psoriatic arthritis (PsA) receiving LTBI screening for biologics from Jan 2013 to April 2014. RESULTS: A total of 238 rheumatic patients who underwent LTBI screening were included in this study, of whom 46 (19.3%) had positive IGRA tests, 178 (74.8%) had negative results, and 14 (5.9%) had indeterminate results. Radiological findings suggesting healed tuberculosis (CXR-old-TB) were found in 18.1% of all patients, 23.9% in the IGRA -positive patients vs 16.9% in the IGRA-negative patients (OR 1.55 95% CI: 0.71–3.39, p = 0.27). Forty (40/46, 87.0%) IGRA-positive patients received isoniazid prophylaxis and 77.5% of them finished treatment. Six patients developed adverse effects of isoniazid treatment, resulting in an overall number needed to harm (NNH) of 6.7 (40/6). IGRA-non-positive patients with old TB-suggestive CXR comprised 13.4% (32/238) of all our rheumatic patients, and one of them developed pulmonary tuberculosis within one year after screening. CONCLUSIONS: LTBI disease burden in rheumatic patients is substantial according to the estimation of CXR and IGRA screening. Correlation between CXR and IGRA is not significant in rheumatic patients, which implies their complementary roles. IGRA-non-positive patients with old TB-suggestive CXR comprise a significant portion in rheumatic patients and merit cautious follow-up by rheumatologists, tuberculosis specialists, and pulmonologists.
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spelling pubmed-74612502020-09-02 Chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients Wang, Ping-Huai Lin, Chou-Han Chang, Ting-Hui Wu, Chien-Sheng BMC Pulm Med Research Article BACKGROUND: A study of latent tuberculosis infection (LTBI) burden by chest roentgenography (CXR) with reference to interferon-gamma release assay (IGRA) is still lacking in rheumatic patients of an intermediate tuberculosis burden area. METHODS: We retrospectively reviewed clinical data of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), or psoriatic arthritis (PsA) receiving LTBI screening for biologics from Jan 2013 to April 2014. RESULTS: A total of 238 rheumatic patients who underwent LTBI screening were included in this study, of whom 46 (19.3%) had positive IGRA tests, 178 (74.8%) had negative results, and 14 (5.9%) had indeterminate results. Radiological findings suggesting healed tuberculosis (CXR-old-TB) were found in 18.1% of all patients, 23.9% in the IGRA -positive patients vs 16.9% in the IGRA-negative patients (OR 1.55 95% CI: 0.71–3.39, p = 0.27). Forty (40/46, 87.0%) IGRA-positive patients received isoniazid prophylaxis and 77.5% of them finished treatment. Six patients developed adverse effects of isoniazid treatment, resulting in an overall number needed to harm (NNH) of 6.7 (40/6). IGRA-non-positive patients with old TB-suggestive CXR comprised 13.4% (32/238) of all our rheumatic patients, and one of them developed pulmonary tuberculosis within one year after screening. CONCLUSIONS: LTBI disease burden in rheumatic patients is substantial according to the estimation of CXR and IGRA screening. Correlation between CXR and IGRA is not significant in rheumatic patients, which implies their complementary roles. IGRA-non-positive patients with old TB-suggestive CXR comprise a significant portion in rheumatic patients and merit cautious follow-up by rheumatologists, tuberculosis specialists, and pulmonologists. BioMed Central 2020-08-31 /pmc/articles/PMC7461250/ /pubmed/32867745 http://dx.doi.org/10.1186/s12890-020-01274-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Wang, Ping-Huai
Lin, Chou-Han
Chang, Ting-Hui
Wu, Chien-Sheng
Chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients
title Chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients
title_full Chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients
title_fullStr Chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients
title_full_unstemmed Chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients
title_short Chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients
title_sort chest roentgenography is complementary to interferon-gamma release assay in latent tuberculosis infection screening of rheumatic patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7461250/
https://www.ncbi.nlm.nih.gov/pubmed/32867745
http://dx.doi.org/10.1186/s12890-020-01274-9
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