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Published on: April 9, 2012
Quantiferon test for tuberculosis screening in sarcoidosis patients
Nils Milman1, Bolette Søborg, Claus Bo Svendsen
1Department of Rheumatology, Rigshospitalet, University of Copenhagen, Copenhagen. nils.mil@dadlnet.dk
Scandinavian Journal of Infectious Diseases
|May 31, 2011
Summary
The QuantiFERON TB Gold (QFN) test reliably screens for latent tuberculosis infection (LTBI) in sarcoidosis patients starting TNF-α inhibitor treatment. QFN results are not affected by disease activity or immunosuppressive drugs.
Area of Science:
- Immunology
- Infectious Disease Epidemiology
- Pulmonology
Background:
- Tumour necrosis factor-alpha (TNF-α) inhibitors are used for refractory sarcoidosis.
- These biologics can reactivate latent tuberculosis infection (LTBI).
- The tuberculin skin test (TST) is limited for LTBI diagnosis in Danish sarcoidosis patients.
Purpose of the Study:
- To assess the reliability of the interferon-gamma release assay (IGRA) QuantiFERON TB Gold (QFN) for diagnosing LTBI in sarcoidosis patients.
- To determine if QFN results are influenced by sarcoidosis disease activity or immunosuppressive treatment.
Main Methods:
- A prospective study of 44 sarcoidosis patients candidates for TNF-α inhibitor treatment (2005-2007).
- QFN screening for LTBI, with disease activity assessed by biochemistry, chest X-rays, and pulmonary function tests.
- Immunosuppressive treatment data obtained from medical records; predictive value evaluated via the Danish National Tuberculosis Registry.
Main Results:
- 93% of patients had negative QFN results, 7% indeterminate.
- Disease activity was present in 43%, and 57% received immunosuppressive treatment.
- No significant difference in QFN response based on disease activity or treatment; no tuberculosis cases observed at follow-up.
Conclusions:
- The QuantiFERON TB Gold (QFN) test demonstrates good predictive value for LTBI screening in Danish sarcoidosis patients.
- QFN results appear unaffected by sarcoidosis disease activity or immunosuppressive therapy.
- This suggests QFN is a reliable tool for pre-treatment LTBI screening in this population.
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