在移植接受者中优化遵守潜在结核病感染查
Alfonso Gotor-Rivera1, Lucia de Jorge-Huerta2, José Tiago Silva2
1Servicio de Dermatología, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, España. alfonso.gotor@salud.madrid.org.
概括
查脏移植接受者潜伏结核感染 (LTBI) 有系统的方法显著改善. 干扰素-释放试验 (IGRA) 显示在该人群中对LTBI查的结核素皮肤试验 (TST) 的坚持率高于结核素皮肤试验.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 移植免疫学 移植免疫学
背景情况:
- 接受脏移植的人患结核病的风险增加.
- 建议对潜伏结核病感染 (LTBI) 进行查,但对移植 (KT) 患者的坚持研究不足.
- ATALANTA-DOS研究评估了KT接受者的LTBI查符合性.
研究的目的:
- 评估对查合规性的系统评估对接受脏移植患者LTBI查率的影响.
- 为了比较干扰素释试验 (IGRA) 和结核素皮肤试验 (TST) 之间的粘附率,用于LTBI查.
- 评估LTBI治疗在这个人群中的有效性.
主要方法:
- ATALANTA-DOS研究比较了KT接受者的干预前和干预队列中的LTBI查率.
- 评估了IGRA和TST的坚持率.
- 在KT后,由传染病专家系统评估了查遵守情况.
主要成果:
- 系统评估显著改善了LTBI查遵守率,从1.3%提高到82.6% (p<0.001).
- 在干预队列中,IGRA显示了比TST (68.1%) 更高的遵守率 (83.3%).
- 在4.4%的患者中检测到LTBI,所有患者都完成了治疗,在随访期间没有发现活性结核病.
结论:
- 对LTBI查合规性的系统评估大大提高了KT接受者的完成率.
- 基于IGRA的策略与TST相比,提高了查合规性,支持它们在KT接受者中的使用.
- 改善的坚持促进了有针对性和有效的LTBI治疗,降低了重新激活的风险.
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