Danjou William, Pradat Pierre, Jamilloux Yvan, Gerfaud-Valentin Mathieu, Kodjikian Laurent, Trad Salim, Seve Pascal
Service de médecine interne, Hôpital de La Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France.
Centre de recherche clinique, Hôpital de La Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
Br J Ophthalmol. 2023 Apr;107(4):500-504. doi: 10.1136/bjophthalmol-2021-318868. Epub 2021 Oct 28.
Few studies have evaluated the contribution of QuantiFERON test for the diagnosis of tubercular uveitis in non-endemic countries for tuberculosis (TB). The objective of the present study was to evaluate the value of the QuantiFERON test in a large cohort of patients with uveitis for both the diagnosis of tubercular uveitis and antituberculosis treatment (ATT) response prediction.
A single-centre retrospective study including consecutive adult patients with uveitis who were prescribed a QuantiFERON test between January 2003 and December 2019 was performed. Adjusted ORs (aORs) were calculated between patients with uveitis responding and not responding to ATT according to the Collaborative Ocular Tuberculosis Study (COTS) group diagnostic criteria. Sensitivity (SE), specificity (Sp), and positive and negative predictive values of the QuantiFERON test were calculated.
A total of 1075 patients were included in the study; 178 (16.5%) were found positive using the QuantiFERON test. Among the 178 positive patients, 62 (35%) had a diagnosis of tubercular uveitis according to the updated COTS classification; all received ATT for 6 months; and 44/62 (71%) responded to ATT. A QuantiFERON test value of >2 IU/mL was associated with a greater chance of responding to ATT (aOR=36.7, 95% CI 7.2 to 185.9, p<0.001). The optimal threshold to maximise both Sp and SE for diagnosis of TB uveitis was 4 IU/mL.
One-sixth of the patients diagnosed with uveitis had a positive QuantiFERON test. The QuantiFERON threshold with the optimal SE and Sp for the diagnosis of tubercular uveitis was 4 IU/mL.
NCT03863782.
在结核病非流行国家，很少有研究评估全血γ干扰素释放试验（QuantiFERON试验）对结核性葡萄膜炎诊断的贡献。本研究的目的是评估QuantiFERON试验在一大群葡萄膜炎患者中对结核性葡萄膜炎诊断和抗结核治疗（ATT）反应预测的价值。
进行了一项单中心回顾性研究，纳入了2003年1月至2019年12月期间连续接受QuantiFERON试验的成年葡萄膜炎患者。根据协作性眼结核研究（COTS）组诊断标准，计算葡萄膜炎患者中ATT有反应者和无反应者之间调整后的比值比（aORs）。计算QuantiFERON试验的敏感性（SE）、特异性（Sp）以及阳性和阴性预测值。
本研究共纳入1075例患者；使用QuantiFERON试验发现178例（16.5%）呈阳性。在这178例阳性患者中，根据更新后的COTS分类标准62例（35%）被诊断为结核性葡萄膜炎；所有患者均接受了6个月ATT；44/62例（71%）对ATT有反应。QuantiFERON试验值>2 IU/mL与对ATT有反应的可能性更大相关（aOR=36.7，95%CI 7.2至185.9，p<0.001）。诊断结核性葡萄膜炎使Sp和SE最大化的最佳阈值为4 IU/mL。
被诊断为葡萄膜炎患者中有六分之一的QuantiFERON试验呈阳性结果。诊断结核性葡萄膜炎具有最佳SE和Sp值的QuantiFERON阈值为4 IU/mL。
NCT03863782
