固体器官移植接受者的潜伏性结核病感染管理:全国快照
Aylin Özgen Alpaydın1, Tuba Yeter Turunç2, Vildan Avkan-Oğuz3
1Department of Pulmonary Diseases, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Thoracic research and practice
|August 11, 2024
概括
在实体器官移植接受者中,移植前的潜伏性结核病感染查不足. 许多患有潜伏结核病的患者没有接受治疗或未登记,这凸显了需要改进风险评估和国家指导方针的需要.
科学领域:
- 移植医学 移植医学
- 传染病流行病学 传染病流行病学
- 公共卫生 公共卫生
背景情况:
- 潜伏性结核感染 (LTBI) 查对于实体器官移植 (SOT) 接受者至关重要.
- 全球许多移植中心的查率仍然低于最佳水平.
- 有效的LTBI管理对于预防移植后结核病至关重要.
研究的目的:
- 评估移植前结核病 (TB) 风险评估的现状.
- 评估在土耳其的SOT接收者中LTBI治疗和国家注册率.
- 为了确定当前LTBI管理协议中的漏洞.
主要方法:
- 对2015-2019年期间接受结核素皮肤测试 (TST) 和/或干扰素释试验 (IGRA) 的成年SOT接受者的回顾性研究.
- 从土耳其各地的14个移植中心收集的数据.
- 通过TST强化≥5毫米或阳性IGRA (QuantiFERON-TB) 定义的LTBI.
主要成果:
- 在2266名SOT接受者中,只有33.8%接受了LTBI的查.
- 在46.9%的查患者中检测到LTBI; 56.5%接受了异化治疗.
- 在接受治疗的人中,55.2%在全国注册,73.2%完成治疗. 结核病发生在1.06%的未接受治疗的患者中.
结论:
- 在土耳其,移植前结核病风险分层不足,仅有三分之一的SOT接受者被评估.
- 在SOT接收者中,LTBI的治疗和注册率低于最佳水平.
- 修订的国家准则对于改善SOT候选国结核病风险管理至关重要.
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