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Latent tuberculosis screening before kidney transplantation in the South of Brazil

BACKGROUND: Tuberculosis (TB) is a prevalent infection after kidney transplantation (KT) in high-burden countries. Latent tuberculosis infection (LTBI) screening includes previous TB history, chest radiograph findings, and tuberculin test (TST) and/or interferon-gamma release assays (IGRAs) results....

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Autores principales: Meinerz, Gisele, da Silva, Cynthia Keitel, Dorsdt, Damaris Mikaela Balin, Adames, Julia Bertoni, Andrade, Julio Pasquali, Ventura, Pedro Enrico, Monteiro, Alexandre de Almeida, Pasqualotto, Alessandro Comarú, Garcia, Valter Duro, Keitel, Elizete
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Nefrologia 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940112/
https://www.ncbi.nlm.nih.gov/pubmed/33999988
http://dx.doi.org/10.1590/2175-8239-JBN-2020-0189
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author Meinerz, Gisele
da Silva, Cynthia Keitel
Dorsdt, Damaris Mikaela Balin
Adames, Julia Bertoni
Andrade, Julio Pasquali
Ventura, Pedro Enrico
Monteiro, Alexandre de Almeida
Pasqualotto, Alessandro Comarú
Garcia, Valter Duro
Keitel, Elizete
author_facet Meinerz, Gisele
da Silva, Cynthia Keitel
Dorsdt, Damaris Mikaela Balin
Adames, Julia Bertoni
Andrade, Julio Pasquali
Ventura, Pedro Enrico
Monteiro, Alexandre de Almeida
Pasqualotto, Alessandro Comarú
Garcia, Valter Duro
Keitel, Elizete
author_sort Meinerz, Gisele
collection PubMed
description BACKGROUND: Tuberculosis (TB) is a prevalent infection after kidney transplantation (KT) in high-burden countries. Latent tuberculosis infection (LTBI) screening includes previous TB history, chest radiograph findings, and tuberculin test (TST) and/or interferon-gamma release assays (IGRAs) results. We aimed to compare our routine LTBI screening of KT candidates and living donors (LD) with their IGRA results, and evaluate if this would improve isoniazid (INH) treatment referral. METHODS: We evaluated adult KT candidates and LD with complete routine LTBI screening and QuantiFERON-TB® Gold In-Tube (QFT) testing. Blood samples were collected from April 4th, 2014 to October 31st, 2018, with follow-up until October 31st, 2019. RESULTS: There were 116 KT recipients, with 30% QFT-positive results. Positive QFT was associated with past TB history (p=0.007), positive TST (p<0.0001), residual radiographic lesions (p=0.003), and diabetes (p=0.035). There were 25 LD, 40% had positive QFT. Positive QFT was associated with a positive TST (p=0.002). Positive QFT results increased INH referral in 80%. Post-transplant TB incidence was 2.6% in a median follow-up of 2 (1-33) months. No variables were associated with post-transplant TB. TB patients had inferior, although non-significant, 5-year graft survival (66.7% vs. 76.5%) (p = 0.402). CONCLUSION: In the present study, the association of QFT to our routine LTBI screening incremented INH treatment referral, but there was still a high incidence of post-transplant TB, possibly related to other forms of infection, such as new exposure and donor transmission.
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spelling pubmed-89401122022-03-22 Latent tuberculosis screening before kidney transplantation in the South of Brazil Meinerz, Gisele da Silva, Cynthia Keitel Dorsdt, Damaris Mikaela Balin Adames, Julia Bertoni Andrade, Julio Pasquali Ventura, Pedro Enrico Monteiro, Alexandre de Almeida Pasqualotto, Alessandro Comarú Garcia, Valter Duro Keitel, Elizete J Bras Nefrol Original Articles BACKGROUND: Tuberculosis (TB) is a prevalent infection after kidney transplantation (KT) in high-burden countries. Latent tuberculosis infection (LTBI) screening includes previous TB history, chest radiograph findings, and tuberculin test (TST) and/or interferon-gamma release assays (IGRAs) results. We aimed to compare our routine LTBI screening of KT candidates and living donors (LD) with their IGRA results, and evaluate if this would improve isoniazid (INH) treatment referral. METHODS: We evaluated adult KT candidates and LD with complete routine LTBI screening and QuantiFERON-TB® Gold In-Tube (QFT) testing. Blood samples were collected from April 4th, 2014 to October 31st, 2018, with follow-up until October 31st, 2019. RESULTS: There were 116 KT recipients, with 30% QFT-positive results. Positive QFT was associated with past TB history (p=0.007), positive TST (p<0.0001), residual radiographic lesions (p=0.003), and diabetes (p=0.035). There were 25 LD, 40% had positive QFT. Positive QFT was associated with a positive TST (p=0.002). Positive QFT results increased INH referral in 80%. Post-transplant TB incidence was 2.6% in a median follow-up of 2 (1-33) months. No variables were associated with post-transplant TB. TB patients had inferior, although non-significant, 5-year graft survival (66.7% vs. 76.5%) (p = 0.402). CONCLUSION: In the present study, the association of QFT to our routine LTBI screening incremented INH treatment referral, but there was still a high incidence of post-transplant TB, possibly related to other forms of infection, such as new exposure and donor transmission. Sociedade Brasileira de Nefrologia 2021-05-17 2021 /pmc/articles/PMC8940112/ /pubmed/33999988 http://dx.doi.org/10.1590/2175-8239-JBN-2020-0189 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Meinerz, Gisele
da Silva, Cynthia Keitel
Dorsdt, Damaris Mikaela Balin
Adames, Julia Bertoni
Andrade, Julio Pasquali
Ventura, Pedro Enrico
Monteiro, Alexandre de Almeida
Pasqualotto, Alessandro Comarú
Garcia, Valter Duro
Keitel, Elizete
Latent tuberculosis screening before kidney transplantation in the South of Brazil
title Latent tuberculosis screening before kidney transplantation in the South of Brazil
title_full Latent tuberculosis screening before kidney transplantation in the South of Brazil
title_fullStr Latent tuberculosis screening before kidney transplantation in the South of Brazil
title_full_unstemmed Latent tuberculosis screening before kidney transplantation in the South of Brazil
title_short Latent tuberculosis screening before kidney transplantation in the South of Brazil
title_sort latent tuberculosis screening before kidney transplantation in the south of brazil
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940112/
https://www.ncbi.nlm.nih.gov/pubmed/33999988
http://dx.doi.org/10.1590/2175-8239-JBN-2020-0189
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