Jerbi Ameni, Feki Sawsan, Chtourou Lassaad, Hachicha Hend, Fourati Hela, Ben Amor Fouzia, Ben Moallem Wafa, Baklouti Sofien, Tahri Nabil, Masmoudi Hatem
Immunology Department, Habib Bourguiba Hospital, University of Sfax, Tunisia.
Immunology Department, Habib Bourguiba Hospital, University of Sfax, Tunisia.
Indian J Tuberc. 2025 Jul;72(3):304-311. doi: 10.1016/j.ijtb.2024.05.007. Epub 2024 May 17.
BACKGROUND/OBJECTIVES: Patients infected with SARS-COV-2 were observed to have a significant occurrence of indeterminate results in interferon-gamma (IFN-ɣ) release assays (IGRAs). However, the results of IGRAs in a post-COVID-19 pandemic context were not studied. We aimed to compare the results of the QuantiFERON®(QFT)-TB Plus test before and after the SARS-CoV-2 pandemic.
We conducted a comparative study at the Immunology department comparing two groups of QFT-TB requests received for the screening of latent tuberculosis infection (LTBI): (A) a control group: including QFT-TB tests received before the COVID-19 pandemic (January 2018-December 2019), and (B) a "post-pandemic" group including QFT-TB tests performed between January and December 2022.
The study included 122 patients, with an average age of 44 years (standard deviation: 1.27) and a female-to-male ratio of 1.17. Of these, 12% exhibited lymphopenia, and 41% were undergoing treatment with immunosuppressive or corticosteroid medications. The control group (n = 60) and the post-pandemic group (n = 62) had comparable rates of negative and positive QFT-TB results (67% vs. 86%, and 5% vs. 6%, respectively). Indeterminate QFT-TB results were significantly higher in the post-pandemic group (8%vs.28%, p = 0.002). Lymphocyte count was significantly lower in the post-pandemic group (1540/μL [400-3430] vs. 2035/μL, p = 0.004) but remained within the lower limit of normal. There was an increased mitogen-induced IFN- ɣ production in the post-pandemic group (6.89 UI/mL [0.1-10] vs. 3.08[0.12-10], p = 0.007). IFN- ɣ production in Nil, Tb1, and Tb2 tubes, white blood cell count, and neutrophil count did not differ between the groups.
In a post-pandemic context, the specific response of T-cells to TB antigens does not seem to be affected. The increased mitogen-induced IFN- ɣ production contrasting with the decreased lymphocyte count is in favor of a sustained cellular immune activation.
背景/目的：观察到感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者在干扰素-γ（IFN-ɣ）释放试验（IGRAs）中出现不确定结果的情况显著。然而，在新冠疫情后背景下IGRAs的结果尚未得到研究。我们旨在比较新冠疫情前后QuantiFERON®（QFT）-TB Plus检测的结果。
我们在免疫科进行了一项比较研究，比较两组因潜伏性结核感染（LTBI）筛查而接受的QFT-TB检测：（A）对照组：包括在新冠疫情之前（2018年1月至2019年12月）接受的QFT-TB检测，以及（B）“疫情后”组，包括在2022年1月至12月期间进行的QFT-TB检测。
该研究纳入了122名患者，平均年龄44岁（标准差：1.27），女性与男性比例为1.17。其中，12%表现为淋巴细胞减少，41%正在接受免疫抑制或皮质类固醇药物治疗。对照组（n = 60）和疫情后组（n = 62）的QFT-TB阴性和阳性结果发生率相当（分别为67%对86%和5%对6%）。疫情后组中QFT-TB不确定结果显著更高（8%对28%，p = 0.002）。疫情后组的淋巴细胞计数显著更低（1540/μL[400 - 3430]对2035/μL，p = 0.004），但仍在正常下限范围内。疫情后组中丝裂原诱导的IFN-ɣ产生增加（6.89 UI/mL[0.1 - 10]对3.08[0.12 - 10]，p = 0.007）。两组之间Nil、Tb1和Tb2管中的IFN-ɣ产生、白细胞计数和中性粒细胞计数没有差异。
在疫情后背景下，T细胞对结核抗原的特异性反应似乎未受影响。丝裂原诱导的IFN-ɣ产生增加与淋巴细胞计数减少形成对比，这有利于持续的细胞免疫激活。
