基于IGRA的INH疗法用于预防移植后的活性结核病:单中心回顾性研究
Jun Zeng1, Daiwen Zhu1, Haohan Zhang1
1Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
International journal of antimicrobial agents
|January 20, 2024
概括
以干扰素-释放试验 (IGRA) 为指导的异化预防有效地预防移植接受者 (KTRs) 的活性结核病 (TB). 这种策略是安全的,在接受治疗的IGRA阳性KTR中没有观察到活跃的结核病例.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 接受移植 (KT) 的人有增加结核病 (TB) 重新激活的风险.
- 预防策略对于预防这一脆弱群体的结核病至关重要.
研究的目的:
- 评估干扰素释测试 (IGRA) 导向的异化 (INH) 预防方案的疗效和安全性.
- 预防结核病感染,用于结核病风险较高的移植受体 (KTRs).
主要方法:
- 从2014年6月到2021年7月,对成年KTR进行了回顾性分析.
- 在KT后评估活跃结核病的发展.
- 对阳性病例进行IGRA检测和随后的INH预防.
主要成果:
- 925名KTR中有12.0%患有活跃结核病;高风险KTR中有14.0%患有结核病,低风险KTR中有9.7% (P=0.05).
- 在IGRA阳性KTR中,没有 (0/40) 接受INH预防的患者患有活跃结核病,而没有预防的患者则为36.4% (8/22) (P<0.01).
- 在高风险的KTR中没有观察到活跃的结核病,具有负的IGRA结果,即使没有INH预防. 肝酶的升高是轻微的,在安全范围内.
结论:
- 一个IGRA指导的异化预防策略是有效的预防活动结核病的发展在KTRs.
- 这一协议在移植接受者中显示出良好的安全性.
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