Diagnosing Latent Tuberculosis in Immunocompromised Patients Measuring Blood IP-10 Production Capacity: An Analysis of Chronic Renal Failure Patients

• Published in: Internal Medicine Vol. 54; no. 5; pp. 465 - 472
• Main Authors: Gunluoglu, Gulsah, Seyhan, Ekrem Cengiz, Kazancioglu, Rumeyza, Gunluoglu, Zeki, Veske, Nurdan Simsek, Yazar, Esra Ertan, Altin, Sedat
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-01-2015
• Subjects: Chemokine CXCL10 - biosynthesis; chronic renal failure; Female; Humans; IGRA; Immunocompromised Host; Interferon-gamma; Interferon-gamma Release Tests; IP-10; Kidney Failure, Chronic - therapy; Latent Tuberculosis - blood; Latent Tuberculosis - diagnosis; latent tuberculosis infection; Male; Middle Aged; Mycobacterium; Renal Dialysis; Risk Factors; TST; Tuberculin Test
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.54.3245

Objective Patients undergoing haemodialysis for chronic renal failure-hemodialysis (CRF-HD) are at risk of latent tuberculosis infection (LTBI). The effectiveness of using blood IP-10 production capacity to diagnose LTBI in CRF-HD patients was analysed. Methods The study enrolled 50 CRF-HD patients. Interferon-γ release assay (IGRA) was done using QuantiFERON-TB Gold In Tube (QFG-IT) system. Blood IP-10 production capacity was measured using the QFG-IT system tubes. Tuberculin skin testing (TST) was performed on the same day and the test results were compared. Results TST turned out to be positive in 36.4% of the patients and QFG-IT in 54% of them. After stimulation with specific tuberculosis antigens, blood IP-10 levels increased noticeably. The antigen-stimulated blood IP-10 level was significantly higher in patients who were either TST or QFG-IT positive than in patients whose tests were negative (p=0.0001). Using 4.02 pg/mL as the threshold for stimulated blood log-transformed IP-10 level, good agreement was observed between IP-10 and QFG-IT results (κ=1). Conclusion Blood IP-10 level, which can be measured simply, provides results equivalent to IGRAs for the diagnosis of LTBI in CRF-HD patients.