Latent Tuberculosis Infection and Associated Factors in Patients with Systemic Lupus Erythematosus: a Multicenter,...

Area of Science:

• Immunology
• Infectious Diseases
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) and tuberculosis (TB) pose significant global health burdens, particularly in China.
• Accurate screening for latent tuberculosis infection (LTBI) in SLE patients is crucial for timely preventive interventions.
• Limited large-scale data exists on LTBI prevalence and influencing factors among SLE patients in China.

Purpose of the Study:

• To screen SLE patients for LTBI using the T-SPOT.TB assay.
• To determine the prevalence of LTBI in this patient cohort.
• To identify factors influencing T-SPOT.TB assay results in SLE patients.

Main Methods:

• A multicenter, cross-sectional study involving 2,229 SLE patients across China.
• Screening for LTBI using the T-SPOT.TB assay.
• Data collection on patient demographics, disease characteristics, and treatments; statistical analysis using logistic regression.

Main Results:

• The overall LTBI positivity rate among SLE patients was 15.0%.
• Factors associated with positive T-SPOT.TB results included age over 40 and prior tuberculosis history.
• Severe SLE disease activity (SLEDAI-2K ≥10), high-dose glucocorticoids (≥60 mg/d), and treatments with leflunomide or tacrolimus were associated with negative T-SPOT.TB results.

Conclusions:

• The T-SPOT.TB assay identified a 15% LTBI prevalence in Chinese SLE patients, lower than the general population.
• Severe SLE disease and specific immunosuppressive therapies can lead to false-negative T-SPOT.TB results.
• Diagnosing LTBI solely on positive T-SPOT.TB results may underestimate prevalence in SLE patients with severe disease or on certain treatments.