Diagnostic value of the interferon-γ release assay for tuberculosis infection in patients with Behçet’s disease

BMC Infectious Diseases - Tập 19 - Trang 1-8 - 2019
Xiuhua Wu1,2, Pang Chen3, Wei Wei2, Mengyu Zhou1, Chaoran Li1, Jinjing Liu1, Lidan Zhao1, Lifan Zhang4, Yan Zhao1, Xiaofeng Zeng1, Xiaoqing Liu4, Wenjie Zheng1
1Department of Rheumatology and Clinical Immunology, Key Laboratory of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Ministry of Education, Beijing, China
2Department of Rheumatology, Tianjin Medical University General Hospital, Tianjin, China
3Department of Rheumatology, Affiliated Mindong Hospital of Fujian Medical University, Fuan, China
4Department of Infectious Diseases, Clinical Epidemiology Unit, International Epidemiology Network, Centre for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China

Tóm tắt

To investigate the diagnostic value of the interferon-γ release assay (IGRA) for detecting tuberculosis (TB) infection in patients with Behçet’s disease (BD). We retrospective analyzed the data collected from 173 BD patients hospitalized between 2010 and 2015. Ninety-nine healthy volunteers were enrolled as a control group. IGRA was performed using T-SPOT.TB. The diagnosis of active TB (ATB) was based on clinical, radiological, microbiological, histopathological information and the response to anti-TB therapy. Latent TB (LTB) infection was defined as asymptomatic patients with positive T-SPOT.TB. TB infection was documented in 59 BD patients (34.1%). The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of T-SPOT.TB for the diagnosis of ATB were 88.9%, 74.8%, 29.1%, 98.3%, 3.53 and 0.15, respectively. The receiver-operating-characteristic curve demonstrated that spot-forming cells (SFCs) of 70/106 PBMC was the optimal cutoff for diagnosing ATB, with an area under the curve of 0.891. Furthermore, the median SFCs in ATB group was significantly higher than those in LTB infection (466/106 PBMC vs. 68/106 PBMC, p = 0.007) or previous TB infection (466/106 PBMC vs. 96/106 PBMC, p = 0.018). A significant discrepancy between T-SPOT.TB and tuberculin skin test was noted (kappa coefficient = 0.391, p = 0.002). T-SPOT.TB, an IGRA, may assist in the diagnosis of ATB in BD patients, and the higher SFCs suggest ATB in BD patients.

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