Analysis of QuantiFERON-TB Gold Plus test results among patients with chronic inflammatory diseases and HIV patients

Objective: Screening for latent tuberculosis(LTB) is necessary, especially for people living with HIV and people receiving anti-TNF therapy. Although there is no microbiological test accepted as the gold standard, interferon-gamma release assays (IGRA) are suggested to be used by World Health Organisation. We aimed to analyse QuantiFERON-TB Gold Plus test results in different patient groups with high reactivation risk.
Methods: Patients admitted to ……………University Hospital Microbiology Laboratory between August 2016 - March 2020 have been analyzed retrospectively. Patient demographic data was obtained from the records of the laboratory information management system. Blood samples have been studied as recommended by the manufacturer (QuantiFERON-TB Gold Plus, QIAGEN, Germany).
Results: We evaluated samples from 1506 patients of whom with a chronic inflammatory disease (CID) in 1223 patients and HIV positivity among 283 patients. Mean age was 38.29± 12.66 for HIV patients and 41.57 ± 14.45 for chronic inflammatory disease patients. QFT test was positive in 319 (21.2%) of 1506 patients in total and in 43 (15.2%) of HIV patients and in 276 (22.6%) of CID patients. Indeterminate results were obtained in 1.7% (n=26) of the samples. Among patients with CID highest rate of QFT test positivity was detected among patients with psoriasis (27.8%), followed by patients with rheumatoid arthritis (21.8%) and ankylosing spondylitis (19.8%). Active tuberculosis was not developed in any of QFT-GIT positive CID patients followed up in our hospital for the 4 years period.
Conclusion: QuantiFERON-TB Gold Plus test requires a short-term and one-time contact with the patient and it seems to be a suitable option for screening of patients who have a high risk of tuberculosis.

Kronik inflamatuar hastalýðý olan hastalarda ve HIV hastalarýnda QuantiFERON-TB Gold Plus test sonuçlarýnýn analizi

Amaç: Latent tüberküloz (LTB) taramasý Özellikle HIV pozitif kiþilerde ve anti-TNF tedavisi görenlerde gereklidir. Altýn standart olarak kabul edilen bir mikrobiyolojik test bulunmamakla birlikte, Dünya Saðlýk Örgütü tarafýndan interferon-gamma salýným testlerinin (IGRA) kullanýlmasý önerilmektedir. Çalýþmamýzda, reaktivasyon riski yüksek farklý hasta gruplarýnda QuantiFERON-TB Gold Plus test sonuçlarýný analiz etmeyi amaçladýk.
Yöntem: ……………… Mikrobiyoloji Laboratuvarýna Aðustos 2016 - Mart 2020 tarihleri arasýnda baþvuran hastalar retrospektif olarak incelendi. Hasta demografik verileri, laboratuvar bilgi yönetim sistemi kayýtlarýndan elde edildi. Kan numuneleri, üretici (QuantiFERON-TB Gold Plus, QIAGEN, Almanya) tarafýndan tavsiye edildiði þekilde incelenmiþtir.
Bulgular: 1223'ü kronik inflamatuvar hastalýk (KIH) ve 283'ü HIV pozitif olan 1506 hastadan alýnan örnekleri deðerlendirdik. Ortalama yaþ HIV hastalarý için 38,29± 12,66, kronik inflamatuar hastalýk hastalarý için 41,57 ± 14,45 idi. Toplam 1506 hastanýn 319'unda (%21,2), HIV hastalarýnýn 43'ünde (%15,2), KIH grubunda (%22,6) QFT testi pozitifti. Örneklerin %1,7'sinde (n=26) belirsiz sonuçlar elde edildi. KAH olanlar arasýnda en yüksek QFT testi pozitifliði psöriazis hastalarýnda (%27,8) iken, bunu romatoid artrit (%21,8) ve ankilozan spondilit (%19,8) izledi. Hastanemizde 4 yýl boyunca takip edilen QFT-GIT pozitif CID hastalarýnýn hiçbirinde aktif tüberküloz geliþmedi.
Sonuç: QuantiFERON-TB Gold Plus testi, hastayla kýsa süreli ve tek seferlik temasý gerektirmekte olup, tüberküloz riski yüksek hastalarýn taranmasý için uygun bir seçenek gibi görünmektedir. (NCI-2023-7-12)