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Free Content Interferon-gamma assays for the diagnosis of tuberculosis infection before using tumour necrosis factor-alpha blockers

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OBJECTIVES: Patients who receive tumour necrosis factor-alpha (TNF-α) blockers are mostly immunosuppressed. A study was performed to investigate whether an interferon-gamma (IFN-γ) assay could represent an alternative approach to the tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection (LTBI) in these patients.

DESIGN: We prospectively enrolled 106 individuals into the study in two groups. Group 1 consisted of 38 healthy individuals and Group 2 included 68 patients with chronic inflammatory diseases evaluated for LTBI before the use of TNF-α blockers.

RESULTS: Of all participants, nine had indeterminate IFN-γ test results. Agreement between the two tests was poor in both groups (κ values respectively −0.54 and 0.18). In a total of 97 subjects, 10 (10.3%) were positive by the IFN-γ test and 49 (50.5%) by TST.

CONCLUSION: We found poor agreement between TST and the IFN-γ test in our study. Our limited preliminary data should be accepted as a basis for designing future studies that will be helpful for physicians to decide whether the IFN-γ test is more sensitive than the TST test in detecting LTBI before the use of TNF-α blockers.
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Keywords: immunosuppression; interferon-gamma; tuberculosis infection; tumour necrosis factor-alpha blockers

Document Type: Regular Paper

Affiliations: 1: Hacettepe University Faculty of Medicine Pediatric Pulmonary Diseases Unit, Ankara, Turkey 2: Hacettepe University Faculty of Medicine Rheumatology Unit, Ankara, Turkey 3: Hacettepe University Faculty of Medicine Pediatric Nephrology and Rheumotology Unit, Ankara, Turkey

Publication date: November 1, 2007

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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