Serial QuantiFERON TB-Gold in-tube testing during LTBI therapy in candidates for TNFi treatment

Filippo Bartalesi, Delia Goletti, Michele Spinicci, Annalisa Cavallo, Letizia Attala, Jessica Mencarini, Ginevra Fiori, Francesca Li Gobbi, Antonia Mantella, Maurizio Benucci, Francesca Prignano, Nicola Pimpinelli, Marco Matucci Cerinic, Enrico Girardi, Alessandro Bartoloni

Research output: Contribution to journalArticle

Abstract

Objectives: To evaluate the T-cell interferon (IFN)-γ response to Mycobacterium tuberculosis-specific antigens during latent tuberculosis infection (LTBI) therapy in candidates for tumor necrosis factor-α inhibitors (TNFi). Methods: 1490 Patients were screened for LTBI. One-hundred and sixty-six of them were treated for LTBI and followed-up with QuantiFERON-TB Gold (QFT-IT) testing at baseline (T0) and therapy completion (T1); 92 subjects were also tested 3-6 months after therapy completion (T2). Results: At T1 the QFT-IT reversion and conversion rates were 24% (27/111) and 18% (10/55), respectively. By multivariate analysis, the likelihood of reversion significantly decreased with older age (>50-60), larger TST size (>15 mm) and higher IFN-γ value at T0 (>1 IU/ml); the likelihood of conversion increased with higher IFN-γ levels at T0 (1 IU/ml) and in female patients. Quantitative data among those who scored QFT-IT-positive at T0 showed a decreasing trend of IFN-γ levels between T0 and T1 that reached statistical significance when T0 was compared to T2, and T1 to T2. Conclusions: The data confirm the difficulty of interpreting the modulation of IFN-γ levels during LTBI therapy. Currently, there is no evidence to support the use of QFT-IT in the clinical practice of monitoring LTBI treatment in candidates for TNFi.

Original languageEnglish
Pages (from-to)346-356
Number of pages11
JournalJournal of Infection
Volume66
Issue number4
DOIs
Publication statusPublished - Apr 2013

Keywords

  • Interferon-γ release assay
  • Latent tuberculosis infection therapy
  • QuantiFERON-TB Gold
  • Rheumatic diseases
  • Tumor necrosis factor-α inhibitors

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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  • Cite this

    Bartalesi, F., Goletti, D., Spinicci, M., Cavallo, A., Attala, L., Mencarini, J., Fiori, G., Li Gobbi, F., Mantella, A., Benucci, M., Prignano, F., Pimpinelli, N., Matucci Cerinic, M., Girardi, E., & Bartoloni, A. (2013). Serial QuantiFERON TB-Gold in-tube testing during LTBI therapy in candidates for TNFi treatment. Journal of Infection, 66(4), 346-356. https://doi.org/10.1016/j.jinf.2012.10.017