Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/119141
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | High rates of indeterminate interferon-gamma release assays for the diagnosis of latent tuberculosis infection in liver transplantation candidates |
Author: | Wigg, A.J. Narayana, S.K. Anwar, S. Ramachandran, J. Muller, K. Chen, J.W. John, L. Hissaria, P. Kaambwa, B. Woodman, R.J. |
Citation: | Transplant Infectious Disease, 2019; 21(3):e13087-e13087 |
Publisher: | John Wiley & Sons |
Issue Date: | 2019 |
ISSN: | 1398-2273 1399-3062 |
Statement of Responsibility: | Alan J. Wigg, Sumudu K. Narayana, Shahzaib Anwar, Jeyamani Ramachandran, Kate Muller, John W. Chen, Libby John, Pravin Hissaria, Billingsley Kaambwa, Richard J. Woodman |
Abstract: | BACKGROUND AND AIMS:Screening for latent tuberculosis infection (LTBI) is recommended prior to solid organ transplantation. Interferon-gamma release assays (IGRAs) are the most widely used test for LTBI screening; however, assessment of IGRA performance in patients with end-stage liver disease is limited. The purpose of this study was to evaluate the prevalence and predictors of indeterminate (INDT) IGRA results in liver transplantation candidates. METHODS:Between March 2011 and May 2018, we retrospectively analyzed 155 patients undergoing liver transplantation assessment, who underwent IGRA testing (Quantiferon-TB Gold, QFT-G) to exclude LTBI. Characteristics of patients, including age, gender, etiology of liver disease, MELD score, and absolute lymphocyte counts, were compared by QFT-G result (determinate vs INDT). RESULTS:Of the 155 patients screened, the rate of positive, negative, and INDT results were 5.2%, 69.8%, and 25%, respectively. The only variable independently associated with an indeterminate test on multivariate analysis was MELD score (odds ratio = 1.07, 95% CI = 1.01-1.14 per unit increase; P = 0.014). In 95% of INDT tests, both TB antigen tube and the positive control tube were negative and repeat testing gave the same indeterminate result, suggestive of anergy rather than laboratory error. CONCLUSIONS:Our study suggests a high rate of INDT IGRA results during screening of liver transplant candidates for LTBI, associated with severity of liver disease and anergy. Because of the high rate of INDT QFT-G testing in this setting, individualized risk assessment is required including a thorough assessment of clinical risk factors and knowledge of local TB prevalence. |
Keywords: | anergy indeterminate interferon-gamma release assay latent tuberculosis liver transplantation |
Rights: | © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd |
DOI: | 10.1111/tid.13087 |
Published version: | http://dx.doi.org/10.1111/tid.13087 |
Appears in Collections: | Aurora harvest 8 Medicine publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.