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在启动TNF-α抑制剂治疗前对自身免疫性疾病患者进行潜伏性结核感染筛查。

Screening for Latent Tuberculosis Infection in Patients with Autoimmune Diseases Before Initiating TNF-α Inhibitors Therapy.

作者信息

Perifanou Dimitra, Zoe Daniil, Petinaki Efthimia, Konstantinou Konstantinos, Gourgoulianis Konstantinos

机构信息

Department of Public Health and Community Health, Unit of Community Health, School of Health Professions, Athens Technological Educational Institute (TEI Athens).

Department of Respiratory Medicine, University of Thessaly School of Medicine, Larissa, Greece.

出版信息

Mater Sociomed. 2018 Mar;30(1):32-37. doi: 10.5455/msm.2018.30.32-37.

Abstract

INTRODUCTION

QFT-GIT is more sensitive than TST in patients under immunosuppressive therapy, but TST detects more cases of LTBI. TST remains an inexpensive test worldwide, which does not need laboratory equipment.

MATERIAL AND METHODS

Overall, 457 patients having autoimmune diseases were referred. Of those referred, 158 patients were screened with QFT-GIT and TST. No patient in the present study was known to be HIV positive, or had a history of tuberculosis contact the last year. Additionally, neither of the two methods distinguish latent from active TB, and neither one is better at recognizing patients with autoimmune diseases who could avail from preventive chemoprophylaxis.

RESULTS

QFT-GIT is more sensitive than TST in patients under immunosuppressive therapy, but TST detects more cases of LTBI. TST remains an inexpensive test worldwide, which does not need laboratory equipment.

CONCLUSION

Since the literature for the economic evaluation of LTBI screening has not clearly defined which test is ultimately more cost-effective, low income countries like Greece should continue using TST as the primary method for diagnosis of LTBI.

摘要

引言

在接受免疫抑制治疗的患者中,QFT-GIT比结核菌素皮肤试验(TST)更敏感,但TST能检测出更多的潜伏性结核感染(LTBI)病例。在全球范围内,TST仍然是一种成本低廉的检测方法,无需实验室设备。

材料与方法

总共转诊了457例患有自身免疫性疾病的患者。在这些转诊患者中,158例患者接受了QFT-GIT和TST筛查。本研究中没有患者已知为HIV阳性,也没有患者在过去一年中有结核接触史。此外,这两种方法都无法区分潜伏性结核和活动性结核,在识别可从预防性化学预防中获益的自身免疫性疾病患者方面也都没有优势。

结果

在接受免疫抑制治疗的患者中,QFT-GIT比TST更敏感,但TST能检测出更多的LTBI病例。在全球范围内,TST仍然是一种成本低廉的检测方法,无需实验室设备。

结论

由于关于LTBI筛查经济评估的文献尚未明确哪种检测最终更具成本效益,像希腊这样的低收入国家应继续将TST作为诊断LTBI的主要方法。

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Detecting latent tuberculosis in compromised patients.在免疫功能低下患者中检测潜伏性结核病。
Curr Opin Infect Dis. 2015 Jun;28(3):275-82. doi: 10.1097/QCO.0000000000000158.
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Advances in diagnosis and treatment of latent tuberculosis infection.潜伏性结核感染的诊断与治疗进展
J Am Board Fam Med. 2014 Sep-Oct;27(5):704-12. doi: 10.3122/jabfm.2014.05.140062.

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