Screening for TB in Hospitalised Patients with Inflammatory Bowel Disease before Anti-TNF Therapy: Is QuantiFERON(R) Gold Testing Useful?



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-.

Access the full-text of this item by clicking on the Open Access link.

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(&#174)
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