Dual latent tuberculosis screening with tuberculin skin tests and QuantiFERON-TB assays before TNF-α inhibitor initiation in children in Spain

被引：0

作者：

Joan Calzada-Hernández

Jordi Anton

Javier Martín de Carpi

Berta López-Montesinos

Inmaculada Calvo

Ester Donat

Esmeralda Núñez

Javier Blasco Alonso

María José Mellado

Fernando Baquero-Artigao

Rosaura Leis

Ana María Vegas-Álvarez

Marta Medrano San Ildefonso

María del Carmen Pinedo-Gago

Francisco Javier Eizaguirre

Alfredo Tagarro

Marisol Camacho-Lovillo

Beatriz Pérez-Gorricho

César Gavilán-Martín

Sara Guillén

Belén Sevilla-Pérez

Luis Peña-Quintana

Pablo Mesa-Del-Castillo

Clàudia Fortuny

Marc Tebruegge

Antoni Noguera-Julian

机构：

[1] Hospital Sant Joan de Déu,Pediatric Rheumatology Division

[2] Institut de Recerca Sant Joan de Déu,Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut

[3] Universitat de Barcelona,Servei de Gastroenterologia

[4] Hepatologia I Nutrició Pediàtrica,Rheumatology Unit, Pediatrics Department

[5] Hospital Sant Joan de Déu - Institut de Recerca Sant Joan de Déu,Pediatric Gastroenterology and Hepatology Unit, Pediatrics Department

[6] University Hospital La Fe,Servicio de Pediatria

[7] University Hospital La Fe,Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatrics Department

[8] UGC de Pediatría,Gastroenterología Infantil

[9] Hospital Regional Universitario de Málaga,Paediatrics Department, Hospital Universitario Infanta Sofía; Paediatrics Research Group

[10] Enfermedades Infecciosas Y Patología Tropical,Servicio de Inmunología, Reumatología e Infectología Pediátrica

[11] Red de Investigación Translacional en Infectología Pediátrica (RITIP),Pediatric Infectious Diseases Unit, Department of Pediatrics

[12] Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC),Servicio de Pediatría

[13] University Clinical Hospital of Santiago (CHUS),Department of Pediatrics

[14] Hospital Universitario Río Hortega de Valladolid,Department of Rheumatology

[15] Reumatología Pediátrica,Malalties Infeccioses I Resposta Inflamatòria Sistèmica en Pediatria, Unitat d’Infeccions, Servei de Pediatria

[16] Hospital Universitario Miguel Servet,Department of Infection, Immunity and Inflammation

[17] Unidad de Reumatología Pediátrica,Department of Paediatrics

[18] Hospital de Cruces,undefined

[19] Unidad de Gastroenterología Infantil,undefined

[20] Hospital Universitario Donostia,undefined

[21] Universidad Europea de Madrid,undefined

[22] Fundación de Investigación Biomédica Hospital 12 de Octubre,undefined

[23] Instituto de Investigación 12 de Octubre (imas12),undefined

[24] Hospital Universitario Virgen del Rocío,undefined

[25] Hospital Infantil Universitario Niño Jesús,undefined

[26] Hospital Universitario San Juan de Alicante,undefined

[27] Hospital Universitario de Getafe,undefined

[28] Unidad de Reumatología,undefined

[29] Servicio de Pediatría del Hospital Universitario San Cecilio de Granada,undefined

[30] Pediatric Gastroenterology,undefined

[31] Hepatology and Nutrition Unit,undefined

[32] Mother and Child Insular University Hospital,undefined

[33] ,undefined

[34] Centro de Investigación Biomédica en Red de Obesidad Y Nutrición (CIBEROBN),undefined

[35] University Institute for Research in Biomedical and Health Sciences,undefined

[36] University of Las Palmas de Gran Canaria,undefined

[37] Hospital Clínico Universitario Virgen de La Arrixaca,undefined

[38] Institut de Recerca Sant Joan de Déu,undefined

[39] Centro de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP),undefined

[40] UCL Great Ormond Street Institute of Child Health,undefined

[41] University College London,undefined

[42] University of Melbourne,undefined

[43] Department of Paediatrics,undefined

[44] Klinik Ottakring,undefined

[45] Wiener Gesundheitsverbund,undefined

来源：

European Journal of Pediatrics | 2023年 / 182卷

关键词：

Inflammatory bowel disease; Interferon-gamma release assay; Juvenile idiopathic arthritis; Pediatrics; Tuberculosis;

D O I：

暂无

中图分类号：

学科分类号：

摘要：

Tumor-necrosis-factor-α inhibitors (anti-TNF-α) are associated with an increased risk of tuberculosis (TB) disease, primarily due to reactivation of latent TB infection (LTBI). We assessed the performance of parallel LTBI screening with tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube assays (QFT-GIT) before anti-TNF-α treatment in children with immune-mediated inflammatory disorders in a low TB-burden setting. We conducted a multicenter cohort study involving 17 pediatric tertiary centers in Spain. LTBI was defined as the presence of a positive TST and/or QFT-GIT result without clinical or radiological signs of TB disease. A total of 270 patients (median age:11.0 years) were included, mainly with rheumatological (55.9%) or inflammatory bowel disease (34.8%). Twelve patients (4.4%) were diagnosed with TB infection at screening (LTBI, n = 11; TB disease, n = 1). Concordance between TST and QFT-GIT results was moderate (TST+/QFT-GIT+, n = 4; TST−/QFT-GIT+, n = 3; TST+/QFT-GIT-, n = 5; kappa coefficient: 0.48, 95% CI: 0.36–0.60). Indeterminate QFT-GIT results occurred in 10 patients (3.7%) and were associated with young age and elevated C-reactive protein concentrations. Eleven of 12 patients with TB infection uneventfully completed standard LTBI or TB treatment. During a median follow-up period of 6.4 years, only 2 patients developed TB disease (incidence density: 130 (95% CI: 20–440) per 100,000 person-years), both probable de novo infections.

引用

页码：307 / 317

页数：10