Characterization of QuantiFERON-TB-Plus results in latent tuberculosis infected patients with or without immune-mediated inflammatory diseases

Teresa Chiacchio, Elisa Petruccioli, Valentina Vanini, Gilda Cuzzi, Umberto Massafra, Gianpiero Baldi, Assunta Navarra, Rossana Scrivo, Claudio Mastroianni, Ilaria Sauzullo, Carmela Esposito, Fabrizio Palmieri, Fabrizio Cantini, Delia Goletti

Research output: Contribution to journalArticle

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Abstract

Objectives: Screening for latent tuberculosis infection (LTBI) diagnosis is mandatory in patients with immune-mediated inflammatory diseases (IMID) requiring biologics. QuantiFERON-TB-Plus (QFT-P), an LTBI diagnostic test, measures IFN-γ after M. tuberculosis-stimulation in TB1 and TB2 tubes in which a “CD4” or a “CD4 and CD8” response is respectively elicited. Aim of this study is to compare the response to QFT-P of IMID-LTBI patients candidates to a new biological therapy vs LTBI-subjects without IMID. Methods: We prospectively enrolled 167 subjects: 61 IMID-LTBI and 106 NON-IMID-LTBI. Results: All subjects were mitogen-responders. IFN-γ production was significantly lower in IMID-LTBI-patients compared to NON-IMID-LTBI-subjects. We observed discordant TB1 and TB2 results in 6.5% of IMID-LTBI-patients and in 8% of NON-IMID-LTBI-subjects. Applying a logistic regression analysis, we found that IMID-LTBI patients had a higher probability (TB1 stimulation OR 3.32; TB2 stimulation OR 4.33) to have IFNγ results ≤0.7 IU/mL compared to NON-IMID-LTBI-subjects. Interestingly, IMID-treatment did not interfere with the distribution of IFNγ-values. Conclusions: These results indicate that IMID-LTBI-patients have a low IFN-γ response to QFT-P, a high proportion of results ranging in the grey zone and a distribution of IFNγ-values independent from the IMID-treatment. These results are important for the management of LTBI screening in IMID patients.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalJournal of Infection
DOIs
Publication statusPublished - Jan 1 2019

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Latent Tuberculosis
Biological Therapy
Biological Products

Keywords

  • Anti-TNFα
  • Biological therapy
  • IGRA
  • IMID
  • LTBI
  • QuantiFERON-TB-Plus
  • Tuberculosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Characterization of QuantiFERON-TB-Plus results in latent tuberculosis infected patients with or without immune-mediated inflammatory diseases. / Chiacchio, Teresa; Petruccioli, Elisa; Vanini, Valentina; Cuzzi, Gilda; Massafra, Umberto; Baldi, Gianpiero; Navarra, Assunta; Scrivo, Rossana; Mastroianni, Claudio; Sauzullo, Ilaria; Esposito, Carmela; Palmieri, Fabrizio; Cantini, Fabrizio; Goletti, Delia.

In: Journal of Infection, 01.01.2019, p. 1-9.

Research output: Contribution to journalArticle

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title = "Characterization of QuantiFERON-TB-Plus results in latent tuberculosis infected patients with or without immune-mediated inflammatory diseases",
abstract = "Objectives: Screening for latent tuberculosis infection (LTBI) diagnosis is mandatory in patients with immune-mediated inflammatory diseases (IMID) requiring biologics. QuantiFERON-TB-Plus (QFT-P), an LTBI diagnostic test, measures IFN-γ after M. tuberculosis-stimulation in TB1 and TB2 tubes in which a “CD4” or a “CD4 and CD8” response is respectively elicited. Aim of this study is to compare the response to QFT-P of IMID-LTBI patients candidates to a new biological therapy vs LTBI-subjects without IMID. Methods: We prospectively enrolled 167 subjects: 61 IMID-LTBI and 106 NON-IMID-LTBI. Results: All subjects were mitogen-responders. IFN-γ production was significantly lower in IMID-LTBI-patients compared to NON-IMID-LTBI-subjects. We observed discordant TB1 and TB2 results in 6.5{\%} of IMID-LTBI-patients and in 8{\%} of NON-IMID-LTBI-subjects. Applying a logistic regression analysis, we found that IMID-LTBI patients had a higher probability (TB1 stimulation OR 3.32; TB2 stimulation OR 4.33) to have IFNγ results ≤0.7 IU/mL compared to NON-IMID-LTBI-subjects. Interestingly, IMID-treatment did not interfere with the distribution of IFNγ-values. Conclusions: These results indicate that IMID-LTBI-patients have a low IFN-γ response to QFT-P, a high proportion of results ranging in the grey zone and a distribution of IFNγ-values independent from the IMID-treatment. These results are important for the management of LTBI screening in IMID patients.",
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T1 - Characterization of QuantiFERON-TB-Plus results in latent tuberculosis infected patients with or without immune-mediated inflammatory diseases

AU - Chiacchio, Teresa

AU - Petruccioli, Elisa

AU - Vanini, Valentina

AU - Cuzzi, Gilda

AU - Massafra, Umberto

AU - Baldi, Gianpiero

AU - Navarra, Assunta

AU - Scrivo, Rossana

AU - Mastroianni, Claudio

AU - Sauzullo, Ilaria

AU - Esposito, Carmela

AU - Palmieri, Fabrizio

AU - Cantini, Fabrizio

AU - Goletti, Delia

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: Screening for latent tuberculosis infection (LTBI) diagnosis is mandatory in patients with immune-mediated inflammatory diseases (IMID) requiring biologics. QuantiFERON-TB-Plus (QFT-P), an LTBI diagnostic test, measures IFN-γ after M. tuberculosis-stimulation in TB1 and TB2 tubes in which a “CD4” or a “CD4 and CD8” response is respectively elicited. Aim of this study is to compare the response to QFT-P of IMID-LTBI patients candidates to a new biological therapy vs LTBI-subjects without IMID. Methods: We prospectively enrolled 167 subjects: 61 IMID-LTBI and 106 NON-IMID-LTBI. Results: All subjects were mitogen-responders. IFN-γ production was significantly lower in IMID-LTBI-patients compared to NON-IMID-LTBI-subjects. We observed discordant TB1 and TB2 results in 6.5% of IMID-LTBI-patients and in 8% of NON-IMID-LTBI-subjects. Applying a logistic regression analysis, we found that IMID-LTBI patients had a higher probability (TB1 stimulation OR 3.32; TB2 stimulation OR 4.33) to have IFNγ results ≤0.7 IU/mL compared to NON-IMID-LTBI-subjects. Interestingly, IMID-treatment did not interfere with the distribution of IFNγ-values. Conclusions: These results indicate that IMID-LTBI-patients have a low IFN-γ response to QFT-P, a high proportion of results ranging in the grey zone and a distribution of IFNγ-values independent from the IMID-treatment. These results are important for the management of LTBI screening in IMID patients.

AB - Objectives: Screening for latent tuberculosis infection (LTBI) diagnosis is mandatory in patients with immune-mediated inflammatory diseases (IMID) requiring biologics. QuantiFERON-TB-Plus (QFT-P), an LTBI diagnostic test, measures IFN-γ after M. tuberculosis-stimulation in TB1 and TB2 tubes in which a “CD4” or a “CD4 and CD8” response is respectively elicited. Aim of this study is to compare the response to QFT-P of IMID-LTBI patients candidates to a new biological therapy vs LTBI-subjects without IMID. Methods: We prospectively enrolled 167 subjects: 61 IMID-LTBI and 106 NON-IMID-LTBI. Results: All subjects were mitogen-responders. IFN-γ production was significantly lower in IMID-LTBI-patients compared to NON-IMID-LTBI-subjects. We observed discordant TB1 and TB2 results in 6.5% of IMID-LTBI-patients and in 8% of NON-IMID-LTBI-subjects. Applying a logistic regression analysis, we found that IMID-LTBI patients had a higher probability (TB1 stimulation OR 3.32; TB2 stimulation OR 4.33) to have IFNγ results ≤0.7 IU/mL compared to NON-IMID-LTBI-subjects. Interestingly, IMID-treatment did not interfere with the distribution of IFNγ-values. Conclusions: These results indicate that IMID-LTBI-patients have a low IFN-γ response to QFT-P, a high proportion of results ranging in the grey zone and a distribution of IFNγ-values independent from the IMID-treatment. These results are important for the management of LTBI screening in IMID patients.

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KW - Biological therapy

KW - IGRA

KW - IMID

KW - LTBI

KW - QuantiFERON-TB-Plus

KW - Tuberculosis

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