隐藏性结核病感染在全基性造血干细胞移植接受者中:常规移植前检查对移植感染病医生的影响 传染病医生
Gabriel Paykin1, Sara Vogrin1,2, Peter Shuttleworth3
1Department of Infectious Diseases and Immunology, Austin Health, Heidelberg, Australia.
概括
移植传染病 (TID) 医生进行的常规移植前检查改善了全源造血干细胞移植 (alloHSCT) 受体的潜伏结核病感染 (LTBI) 查和治疗启动. 这种主动的方法确定了更多面临LTBI管理风险的患者.
科学领域:
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
- 移植医学 移植医学
背景情况:
- 隐性结核感染 (LTBI) 的鉴定在免疫功能低下的患者中是困难的,包括全源造血干细胞移植 (alloHSCT) 接受者.
- 在这些脆弱人群中,LTBI测试的诊断准确性有限.
- 由移植传染病 (TID) 医生进行的常规移植前审查评估了其对LTBI查的影响.
研究的目的:
- 评估常规的移植前TID医生审查对ALLOHSCT接受者的LTBI查和治疗启动的影响.
- 评估TID审查是否改善了在这个患者群体中识别LTBI风险因素.
- 分析LTBI治疗启动模式,有和没有TID审查.
主要方法:
- 在2018年1月至2022年12月期间,对成年alloHSCT接受者的回顾性分析.
- 患者被分为两组:有和没有常规移植前TID医生审查的患者.
- 关于LTBI查,风险因素和治疗开始的数据是从医疗记录中提取的.
主要成果:
- 在116名参与者中,61.2%的参与者有记录的TID审查.
- 一次性创伤治疗的审查与显著更高的LTBI治疗开始相关 (8.5%对比0.0%).
- 在TID审查组中,在没有确定的免疫诊断标准的情况下,LTBI治疗更频繁地开始 (7.1%对比0.0%).
结论:
- 常规的移植前TID审查提高了LTBI风险因素的识别,并增加了高风险aloHSCT患者的治疗开始.
- 需要进行进一步的研究,以确定在低流行性环境中防止LTBI重新激活的最佳策略.
- 常规移植前TID审查的实用性要求对aloHSCT接受者进行进一步的调查.
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