Teresa Chiacchio1, Elisa Petruccioli1, Valentina Vanini1, Gilda Cuzzi1, Umberto Massafra2, Gianpiero Baldi3, Assunta Navarra4, Rossana Scrivo5, Claudio Mastroianni6, Ilaria Sauzullo6, Carmela Esposito7, Fabrizio Palmieri8, Fabrizio Cantini7, Delia Goletti9. 1. Translational Research Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Via Portuense 292, 00149 Rome, Italy. 2. Department of Internal Medicine, S. Pietro Fatebenefratelli Hospital, Rome, Italy. 3. Rheumatology Unit, San Paolo Hospital, Civitavecchia, Rome, Italy. 4. Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Italy. 5. Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy. 6. Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy. 7. Department of Rheumatology, Hospital of Prato, Prato, Italy. 8. Department of Clinical and Clinical Research, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS Rome, Italy. 9. Translational Research Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Via Portuense 292, 00149 Rome, Italy. Electronic address: delia.goletti@inmi.it.
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.
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-LTBIpatients 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 IMIDpatients.
Authors: E Petruccioli; C Farroni; G Cuzzi; V Vanini; F Palmieri; P Vittozzi; D Goletti Journal: Int J Tuberc Lung Dis Date: 2022-01-01 Impact factor: 2.373
Authors: Jonathan W Uzorka; Jaap A Bakker; Krista E van Meijgaarden; Eliane M S Leyten; Nathalie M Delfos; David J Hetem; Jos Kerremans; Mieke Zwarts; Sandra Cozijn; Tom H M Ottenhoff; Simone A Joosten; Sandra M Arend Journal: Eur Respir J Date: 2022-08-10 Impact factor: 33.795