Serial interferon-gamma release assays for latent tuberculosis in dialysis patients with end stage renal disease in a Korean population

Seung Heon Lee, Hee Jin Kim, Seok Ju Park, Tae Hee Kim, So Jeong Park, Sun Woo Kang, Yeong Hoon Kim, Dick Menzies

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Serial interferon-gamma-release-assay (IGRA) result can show variance due to within-subject variation and difference in host immune status, and may be affected by latent tuberculosis infection (LTBI) treatment. We aimed to know the changes in QFT-IT (QuantiFERON-TB Gold In-Tube) results measured at a 4 month interval in end stage renal disease patients and whether these changes were influenced by dialysis method or LTBI treatment. Methods: We prospectively performed serial QFT-IT tests at 4 month interval in 93 end stage renal disease (ESRD) patients on HD (hemodialysis) or PD (peritoneal dialysis). LTBI treatment was given to 18 of 39 patients with initial positive QFT-IT result. Agreement between the two results was estimated for all 93 patients and reversion rates were estimated among the 39 patients with initial positive QFT-IT. Results: Positive QFT-IT at the first and 2nd tests were 41.9 and 34.4 %, respectively. The concordance rate between baseline QFT-IT and 2nd QFT in 93 ESRD patients was excellent (90.3 %, kappa = 0.80, p < 0.001). Agreement between the first QFT-IT and 2nd QFT-IT in HD (95.3 %, kappa = 0.91, p < 0.001) was higher than in PD patients (86.0 %, kappa = 0.69, p < 0.001). Among all ESRD patients, the odds of reversion of QFT-IT was not different in those who were, or were not treated for LTBI [odds ratio = 2.3 (0.5-11.4), p = 0.43]. Conclusions: In a group of 93 dialyzed ESRD patients 8.6 % showed reversion of initial positive QFT to negative within 4 months. Reversion seemed not to be associated with LTBI treatment. Further study with larger numbers of patients is needed to investigate the variation of QFT-IT tests in dialyzed ESRD patients.

Original languageEnglish
Article number381
JournalBMC Infectious Diseases
Volume15
Issue number1
DOIs
Publication statusPublished - 2015 Sep 21

Keywords

  • Dialysis
  • End stage renal disease
  • Interferon-gamma release assay
  • Latent tuberculosis
  • Reversion

ASJC Scopus subject areas

  • Infectious Diseases

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