IGRA testing in patients with immune-mediated inflammatory diseases: which factors influence the results?

• Published in: Rheumatology international Vol. 38; no. 2; pp. 267 - 273
• Main Authors: González-Moreno, Juan, García-Gasalla, Mercedes, Losada-López, Inés, Cifuentes Luna, Carmen, Mir Viladrich, Isabel, Fernández-Baca, Victoria, Serrano, Araceli, Juan Mas, Antonio, Riera-Oliver, Joan, Payeras Cifre, Antoni
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2018; Springer Nature B.V
• Subjects: Adolescent; Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - adverse effects; Adult; Aged; Aged, 80 and over; Chi-Square Distribution; Female; Humans; Immunocompromised Host; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Infection and Immunity; Inflammation - diagnosis; Inflammation - drug therapy; Inflammation - immunology; Interferon-gamma Release Tests; Latent Tuberculosis - diagnosis; Latent Tuberculosis - immunology; Latent Tuberculosis - microbiology; Logistic Models; Lymphocyte Count; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Odds Ratio; Predictive Value of Tests; Reproducibility of Results; Retrospective Studies; Rheumatology; Risk Factors; Spain; Tuberculin Test; Young Adult; Tuberculosis infection; Autoimmune diseases; Quantiferon; IGRA
• ISSN: 0172-8172; 1437-160X
• DOI: 10.1007/s00296-017-3852-9

Diagnosis of latent tuberculosis infection in patients with immune-mediated inflammatory chronic diseases (IMIDs) can be challenged as diagnostic test reliability could be impaired by immunosuppression. We retrospectively analyzed the Quantiferon Gold-Test in-Tube (QFT-G-IT) results of all patients with IMIDs seen at the Department of Internal Medicine of Son Llàtzer Hospital, Palma de Mallorca (Spain), looking for the factors related to QFT-G-IT indeterminate results. During the study period (2008–2015), 520 patients met the inclusion criteria. Factors associated with indeterminate QFT-G-IT results in a univariate analysis were inflammatory bowel disease, disease activity, lymphopenia, and medium-to-high doses of corticosteroids. In a subsequent multivariate analysis, only lymphopenia (defined as < 1500 cells) was associated with indeterminate QFT-G-IT results. Lymphocyte count was the only factor independently associated with an increased number of indeterminate QFT-G-IT results in patients with different autoimmune diseases. Others factors such as the use of medium-to-high doses of corticosteroids should be considered before testing with QFT-G-IT.