Mehmet Ali UÇAR, Hayriye SAYARLIOĞLU, Murat ŞAHİN, Ekrem DOĞAN, Mümtaz Kerim TAHTA, Mehmet SAYARLIOĞLU, Mustafa GÜL, Nurhan KÖKSAL, Canan DAĞLI EREN

QuantiFERON-TB Gold test for screening latent tuberculosis infection in hemodialysis patients

Genel popülasyonla karşılaştırıldığında hemodiyaliz hastalarında latent tüberküloz infeksiyonu (LTBİ) riski artmıştır. Hemodiyaliz hastalarında LTBİ araştırılmasında QuantiFERON-TB Gold (QFT-G) test tüberküloz cilt testi (TCT)’nden daha umut vericidir. Çalışmanın amacı hemodiyaliz hastalarındaki LTBİ tanısında QFT-G’nin TCT’den daha hassas olup olmadığını belirlemektir. LTBİ için TCT ve QFT-G ile 89 hemodiyaliz hastası değerlendirildi. Tüm hastalarda QFT-G için kan alındıktan sonra TCT uygulandı. Demografik veriler, laboratuvar testleri, göğüs radyogramı sonuçları ve BCG aşılama durumu standart hasta dosyalarından sağlandı. Kırk hastada QFT-G pozitifti. Elli altı hastanın TCT indürasyonu 5 mm’nin, 28 hastanın 10 mm’nin üzerindeydi. Altmış bir hastada BCG skarı vardı. TCT ve QFT-G arasında anlamlı istatistiksel korelasyon saptandı (p< 0.05). BCG aşısız subgrupta TCT 8 (%29) hastada pozitif, QFT-G 11 (%39) hastada pozitifti. Yirmi bir aşısız hastada her iki test sonuçlarındaki uyum %82 κ= 0.61, p= 0.001 idi. BCG aşısız hemodiyaliz hastalarında LTBİ için TCT ve QFTG test arasındaki uyum iyi iken, aşılı hastalardaki uyum kötü olarak bulundu. BCG aşılaması ülkemizde yaygın olarak kullanıldığından QFT-G test, LTBİ şüphe edilen hemodiyaliz hastalarında TCT’den daha kullanışlı bir test olabilir.

Hemodiyaliz hastalarında latent tüberküloz infeksiyonu taramasında QuantiFERON-TB Gold test

Hemodialysis patients are at increased risk of latent tuberculosis infection (LTBI) compared with the general population. QuantiFERON-TB Gold (QFT-G) for LTBI detection is more promising than tuberculin skin test (TST) in hemodialysis patients. The aim of this study is to determine whether the QFT-G is more sensitive than the TST in hemodialysis patients in LTBI. Eighty nine hemodialysis patients were evaluated for latent tuberculosis infection with the TST and QFT-G. Blood was obtained for QFT-G, and then TST was administered to all patients. Demographic information, laboratory tests, chest radiography results and BCG vaccination status were collected on standardized patient medical files. Forty patients had positive QFT-G results. 56 patients had TST induration above 5 mm, 28 patients above 10 mm. 61 patients had BCG vaccination scar. Statistically significant correlation was detected between TST and QFT-G (p< 0.05). In the BCG non-vaccinated subgroup, TST was positive in 8 (29%) patients and the QFT-G was positive in 11 (39%). Among the 21 non vaccinated patients with results for both tests, the concordance between the TST and QFT-G was 82%, κ= 0.61, p= 0.001. We found good agreement between the TST and QFT-G test for LTBI in non vaccinated hemodialysis patients, whereas we found poor agreement in vaccinated patients. Because BCG vaccination is widely used in our country, the QFT-G test might be more useful for the diagnosis of LTBI than TST in hemodialysis patients who are suspected to have LTBI.

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