Lovatt, Jessica, Gascoyne-Binzi, Deborah, Hussey, Thomas, Garside, Maya, McGill, Fiona ORCID: 0000-0002-0903-9046 and Selinger, Christian P
(2021)
Screening for TB in Hospitalised Patients with Inflammatory Bowel Disease before Anti-TNF Therapy: Is QuantiFERON(R) Gold Testing Useful?
JOURNAL OF CLINICAL MEDICINE, 10 (9).
1816-.
Abstract
Background-Tumour necrosis factor alpha (TNFα) plays an important role in the pathogenesis of inflammatory bowel disease (IBD) and in immunity to <i>Mycobacterium tuberculosis.</i> Patients should be tested for latent tuberculosis infection using interferon-gamma release assays (IGRA/QF) prior to anti-TNFα therapy. Indeterminate QF results can delay anti-TNFα therapy. We sought to investigate factors associated with indeterminate QF results. Method-Retrospective study of all IGRA tests requested for gastroenterology patients in 2017. We compared inpatients and outpatients and investigated factors potentially associated with QF usefulness (steroid exposure, C-reactive protein (CRP), hypoalbuminaemia, thrombophilia). Results-We included 286 outpatients and 74 inpatients with IBD. Significantly more inpatients had an indeterminate IGRA (52.7% vs. 3.14% in outpatients; <i>p</i> < 0.0001). Laboratory parameters reflecting inflammation (high CRP, low albumin, low haemoglobin and high platelets) were also associated with an indeterminate QF (<i>p</i> < 0.0001). Exposure to steroids was more common in patients with an indeterminate QF (<i>p</i> < 0.0001). A binary logistic regression analysis revealed inpatient status and steroid exposure to be independently predictive of an indeterminate QF (<i>p</i> < 0.0001). Conclusion-There is a high chance of indeterminate QF results in inpatients. QF testing should ideally be performed in the outpatient setting at diagnosis.
Item Type: | Article |
---|---|
Uncontrolled Keywords: | inflammatory bowel disease, latent tuberculosis, QuantiFERON(®) |
Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
Depositing User: | Symplectic Admin |
Date Deposited: | 10 Jun 2021 09:00 |
Last Modified: | 10 Feb 2024 03:17 |
DOI: | 10.3390/jcm10091816 |
Open Access URL: | https://doi.org/10.3390/jcm10091816 |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3125839 |