Latent tuberculosis screening tests and active tuberculosis infection rates in Turkish inflammatory bowel disease patients under anti-tumor necrosis factor therapy

 
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Annals of Gastroenterology
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Latent tuberculosis screening tests and active tuberculosis infection rates in Turkish inflammatory bowel disease patients under anti-tumor necrosis factor therapy (EN)

Alper, Emrah
Ünsal, Belkıs
Dallı, Ayşe
Çekiç, Cem
Topal, Firdevs
Aslan, Fatih
Yüksel, Elif Sarıtaş
Vatansever, Sezgin

Background Tumor necrosis factor (TNF)-α inhibitors increase the risk of tuberculosis (TB). The objective of the present study was to determine the rate of active TB infection in inflammatory bowel disease (IBD) patients receiving anti-TNF therapy and to determine the results of their latent TB infection (LTBI) screening tests during the follow up.Methods This is a retrospective observational study of IBD patients receiving anti-TNF therapy. Tuberculin skin test (TST), interferon-γ release assay (IGRA), and chest radiography were used to determine LTBI. Active TB infection rate during anti-TNF treatment was determined.Results Seventy-six IBD patients (25 with ulcerative colitis, 51 with Crohn's disease; 53 male; mean age 42.0±12.4 years) were included. Forty-four (57.9%) patients received infliximab and 32 (42.1%) adalimumab. Their median duration of anti-TNF therapy was 15 months. Forty-five (59.2%) patients had LTBI and received isoniazid (INH) prophylaxis. During the follow-up period, active TB was identified in 3 (4.7%) patients who were not receiving INH prophylaxis. There was a moderate concordance between the TST and the IGRA (kappa coefficient 0.44, 95% CI 0.24-0.76). Patients with or without immunosuppressive therapy did not differ significantly with respect to TST (P=0.318) and IGRA (P=0.157).Conclusion IBD patients receiving anti-TNF therapy and prophylactic INH have a decreased risk of developing active TB infection. However, despite LTBI screening, the risk of developing active TB infection persists.Keywords Inflammatory bowel disease, anti-TNF therapy, tuberculosis, interferon-γ release assay, tuberculin skin testAnn Gastroenterol 2015; 28 (2): 241-246 (EN)

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion

Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Society of Gastroenterology (EN)

2015-03-27


Hellenic Society of Gastroenterology (EN)

1792-7463
1108-7471
Annals of Gastroenterology; Volume 28, No 2 (2015); 241 (EN)



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