Rheumatology Medical News about positive conversion;tuberculin skin test;interferonrelease assay; hidden tuberculosis infection;anti-tumor necrosis factor

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Positive conversion of tuberculin skin test and performance of interferon release assay to detect hidden tuberculosis infection during anti-tumor necrosis factor agent trial
Journal of Rheumatology, 09/14/09

Park JH et al. – Serial TST with IFN assay may be useful to identify false-negative response to cases of latent Mycobacterium tuberculosis infection and new TB infections in patients with immune mediated inflammatory diseases during longterm anti-TNF therapy, especially in areas with intermediate TB burden.

Methods

86 patients with rheumatic diseases who had received anti-TNF agents for over 1 year
Clinical data obtained from medical records
All received followup TST, and IFN assay was performed in 64

Results

The TST converted to positive in 28 (32.6%) patients
No significant variation between TST conversion rate and all risk factors
Odds of the TST conversion rate tended to increase with duration of TNF antagonist administration
9 of 64 patients who performed an IFN assay had positive results
Among 28 TST positive conversion cases, 4 with AS and 1 with psoriatic arthritis had positive IFN assay results
1 developed miliary TB
None of 4 RA patients with positive IFN-? assay showed TST conversion.
68.6% agreement between TST and IFN assay results

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