quantiferon-tb gold in tube assay for the screening of tuberculosis before and during treatment with tumor necrosis factor alpha antagonistsquantiferon-tb黄金管试验筛选结核病治疗之前和期间的肿瘤坏死因子α拮抗剂.pdfVIP

Hatemi et al. Arthritis Research Therapy 2012, 14:R147 /content/14/3/R147 RESEARCH ARTICLE Open Access Quantiferon-TB Gold in tube assay for the screening of tuberculosis before and during treatment with tumor necrosis factor alpha antagonists 1 1* 2 1 1 Gulen Hatemi , Melike Melikoglu , Fatma Ozbakir , Koray Tascilar and Hasan Yazici Abstract Introduction: The usefulness of interferon-gamma (IFN-g) release assays for tuberculosis screening before tumor necrosis factor-alpha (TNF-a) antagonists and for monitoring during treatment is a contraversial issue. The aims of this study were to determine whether TNF-a antagonists affect the results of the Quantiferon-TB Gold in-tube assay (QTF); to assess how QTF performs in comparison with the tuberculin skin test (TST) in rheumatoid arthritis (RA) patients who are about to start treatment with TNF-a antagonists, RA patients who are not candidates for treatment with TNF-a antagonists, rheumatology patients with confirmed current or past tuberculosis infection, and healthy controls, and to determine the specificity of the QTF test to differentiate leprosy patients, another group of patients infected with mycobacteria. Methods: The 38 RA patients who were prescribed TNF-a antagonists, 40 RA patients who were not considered for TNF-a antagonist use, 30 rheumatology patients with a history or new diagnosis of tuberculosis, 23 leprosy patients, and 41 healthy controls were studied. QTF and TST were done on the same day, and both were repeated after a mean of 3.6 ± 0.2 months in patients who used TNF-a antagonists. Results: Treatment with TNF-a antagonists did not cause a significant change in the QTF or TST positivity rate (34% versus 42%; P = 0.64; and 24% ver