잠시만 기다려 주세요. 로딩중입니다.

Comparative evaluation of QuantiFERON-TB Gold Plus for diagnosis of latent tuberculosis infection during solid organ transplantation

대한이식학회지 2020년 34권 1호 p.8 ~ 14
 ( Yoon Sun-Joo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Laboratory Medicine and Genetics

권원경 ( Kwon Won-Kyung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Laboratory Medicine and Genetics
 ( Jeong Mi-Jeong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Laboratory Medicine and Genetics
 ( Lee Jin-Young ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Laboratory Medicine and Genetics
오하영 ( Oh Ha-Young ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
허우성 ( Huh Woo-Seong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
장혜련 ( Jang Hye-Ryoun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
조재원 ( Joh Jae-Won ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
김종만 ( Kim Jong-Man ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
최규성 ( Choi Gyu-Seong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
김성주 ( Kim Sung-Joo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
박재범 ( Park Jae-Berm ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
이교원 ( Lee Kyo-Won ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
신동현 ( Sinn Dong-Hyun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
최진오 ( Choi Jin-Oh ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
강은숙 ( Kang Eun-Suk ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Laboratory Medicine and Genetics

Abstract


Background: The diagnosis of latent tuberculosis infection (LTBI) in solid organ transplantation (SOT) patients under lifelong immunosuppression has profound effects on preoperative and postoperative management. Interferon-gamma release assay (IGRA) is widely used to screen LTBI before or after transplantation.

Methods: We evaluated the effect of posttransplantation immunosuppression on IGRA and influencing factors by measuring interval change of QuantiFERON-TB Gold Plus (QFT-Plus) between pretransplantation (pre-QFT-Plus) and posttransplantation (post-QFT-Plus) state in 20 patients who previously had reactive IGRA but not taken LTBI treatment.

Results: Eleven (55%) out of 20 pre-QFT-Plus reactive patients became nonreactive state in repeated QFT-Plus (post-QFT-Plus) at 194?413 days (median, 257 days) after transplantation (discordant group). Even in persistently reactive group (concordant group), interferon-gamma (IFN-γ) levels after transplantation were decreased about 34% and 36% of their pretransplantation levels for TB1 and TB2, respectively. The only significant factors that affect interval change of QFT-Plus between pre- and post-SOT status were the concentrations of IFN-γ in pre-QFT-Plus (6.93 vs. 0.44 IU/mL in TB1 and 7.33 vs. 0.71 IU/mL in TB2).

Conclusions: The reactivity of QFT-Plus is significantly compromised by immunosuppressive therapy, which increase the risk of false negative, particularly in patients with low level of IGRA reactivity. Therefore, interpretation of IGRA under immunosuppressive treatment require a caution and eventually, more sensitive tuberculosis-specific cytokine markers might be needed.

키워드

Organ transplantation; Interferon-gamma releasing assay; Immunosuppression
원문 및 링크아웃 정보
 
등재저널 정보