Introduction: Screening for latent tuberculosis infection (LTBI) before kidney transplantation (KT) is indispensable process in kidney transplant recipients (KTRs). The purposes of this study were to compare the QuantiFERON-TB Gold In-Tube test (QFT-GIT) with the tuberculin skin test (TST) for the screening of LTBI in KTRs and to determine predictors correlating to results of each screening method.
Methods: We prospectively compared the results of QFT-GIT to TST in KTRs between July 2008 and July 2012. KTRs were screened for LTBI with both QFT-GIT and TST. Isoniazid (INH) prophylaxis was applied to KTRs with positive TST or positive QFT-GIT or clinical risk factors for LTBI. Post-transplant tuberculosis (TB) was diagnosed by obvious clinical evidence.
Results: A total of 97 patients were tested with QFT-GIT and TST during the study period (mean follow-up 24.6 ± 14.4month). Among them, 19 (20.4%) and 12 (12.9%) had positive QFT-GIT and TST results respectively, the overall agreement between tests was 79.3% (Κ=0.27, 95% confidence interval [CI] -0.03 to 0.50, P <0.014). The incidence of TB was 0.52 per 100 person-years (95% CI 0.02-3.68). No patients developed TB in INH prophylaxis group, whereas one patient in no prophylaxis group developed TB at 14 months after KT. Sensitivity of the two tests could not be compared because patient which showed positive result of QT-GIT or TST did not develop TB. The difference of specificity between QFT-GIT (79.3%) and TST (86.9%) was not statistically significant (P=0.167). Abnormal chest radiograph (OR 27.94, 95% CI 1.22-636.61, P=0.037) and positive TST (OR 7.65, 95% CI 1.75-33.30, P=0.007) were significantly associated with positive QFT-GIT results. Only positive QFT-GIT (OR 6.03, 95% CI 1.51-24.01, P=0.011) was associated with positive TST results.
Conclusions: QFT-GIT and TST for the diagnosis of LTBI in KTRs showed reasonable concordance between tests. However, it could not be determined superiority between QFT-GIT and TST.
To cite this abstract in AMA style:Kim C, Jung H, Kim K, Lim J, Kwon O, Choi J, Cho J, Park S, Kim Y. Comparison of QuantiFERON-TB Gold with Tuberculin Skin Test for Detecting Latent Tuberculosis Infection before Kidney Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/comparison-of-quantiferon-tb-gold-with-tuberculin-skin-test-for-detecting-latent-tuberculosis-infection-before-kidney-transplantation/. Accessed November 29, 2020.
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