Inflammatory markers and clinical characteristics for predicting persistent positivity of interferon gamma release assay in dialysis population
نویسندگان
چکیده
The interferon-gamma release assay (IGRA) is useful for diagnosing latent tuberculosis infection (LTBI), however the rate of negative conversion is high, especially in dialysis patients. Few studies have focused on predicting persistently positive patients who are at high risk of tuberculosis reactivation. We screened dialysis patients, and used QuantiFERON-TB Gold In-tube (QFT-GIT) to identify LTBI. Of the 157 participants who had initially positive QFT-GIT, 82 had persistently positivity and 75 had negative conversion. The persistently positive group were younger, more were current smokers, and had higher plasma level of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and QFT-GIT responses than the negative conversion group. Multivariate logistic regression for persistent positivity revealed that high plasma sTREM-1 and QFT-GIT response, young age and TB contact history were independent factors. Currently smoking had borderline significance. The area under the receiver operating characteristic curve using the multi-factor model was 0.878, higher than 0.821 by QFT-GIT response of 0.95 IU/ml. In conclusion, dialysis patients with persistent LTBI status may be associated with a young age, high plasma sTREM-1, strong QFT-GIT response, currently smoking, and TB contact history. If resources are limited, these five predictors can be used to prioritize QFT-GIT-positive dialysis patients for LTBI treatment.
منابع مشابه
The Effects of Nigella Sativa Oil on Serum Levels Inflammatory Markers, Oxidative Stress Markers, and Lipid Profile in Dialysis Patients: A Double-Blind Clinical Trail
Background: High concentrations of serum inflammatory and oxidative stress markers and lipid abnormities are important risk factors for cardiovascular diseases in hemodialysis patients. This study aims to investigate the effects of Nigella sativa oil on serum levels inflammation and oxidative stress markers and lipid profile in hemodialysis patients. Methods: Fifty hemodialysis patients partici...
متن کاملExpression Pattern of Interferon-γ in Human Leukemic T Cell Lines Following Treatment with Phytoheamagglutinin, phorbol myristate acetate and Lipopolysaccharide
Background: As a T helper type 1 (Th1) derived cytokine, Interferon gamma (IFN-γ) is an important regulator of inflammatory immune responses. Furthermore, IFN-γ plays an essential role in defense against tumors and intracellular pathogens. This study was designed to assess the pattern of IFN-γ production in human leukemic (Jurkat and Molt-4) T cell lines in vitro. Methods: Ju...
متن کاملHigh prevalence of latent tuberculosis infection in dialysis patients using the interferon-gamma release assay and tuberculin skin test.
BACKGROUND AND OBJECTIVES Patients in ESRD on hemodialysis with latent tuberculosis (TB) infection have 10 to 25 times the risk of reactivation into active disease compared with healthy adults. This study investigates the prevalence of latent TB infection in dialysis patients from a country with an intermediate burden of TB and its associated risk factors using the QuantiFERON-TB Gold in-tube t...
متن کاملThe Role of the Interferon Gamma Release Assay in Assessing Recent Tuberculosis Transmission in a Hospital Incident
In 2007, an extensive contact screening investigation into onward transmission of tuberculosis was instigated at a hospital in Northern Ireland following diagnosis of pulmonary multi-drug resistant TB in a healthcare worker. Interferon gamma release assays (IGRAs) were used to test 333 patients and 98 staff. We investigated for evidence of onward transmission and recent infection based on analy...
متن کاملHigh background rates of positive tuberculosis-specific interferon-γ release assays in a low prevalence region of UK: a surveillance study
BACKGROUND Background rates of latent tuberculosis infection in low prevalence regions of Britain are unknown. These would be valuable data for interpreting positive IGRA results, and guiding cost-benefit analyses. The management of a large outbreak of tuberculosis occurring in a rural district hospital provided an opportunity to determine the background rates and epidemiology of IGRA-positivit...
متن کامل