RT Journal Article
SR Electronic
T1 The performance of flow cytometry in the diagnosis of latent tuberculosis infection in patients under treatment with anti-TNFa and other biological agents
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1600
VO 42
IS Suppl 57
A1 Chrysovalantis Papageorgiou
A1 Maria Ploussi
A1 Simona Karabela
A1 Kyriakos Fotiadis
A1 Andreas Anastasopoulos
A1 Apostolos Papavasileiou
A1 Evangelos Vogiatzakis
A1 Dimitrios Ioakeimidis
A1 Angelos Gritzapis
A1 Nikolaos Poulakis
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P1600.abstract
AB Introduction: Detection of IFN-γ synthesis in the cytoplasm of activated CD4+ T cells by flow cytometry [intracellular cytokine flow cytometry (ICCFC)] is a new method to diagnose tuberculosis (TB) infection. The aim of this study is to investigate the performance of Mantoux, Quantiferon Gold In-tube (QFN-G-IT) and ICCFC in patients with collagen vascular diseases who are on treatment with biological agents, including anti-TNFa.Methods: Mantoux, QFN-G-IT and ICCFC were performed in 54 medically immunosuppressed patients and in a cohort of immunocompetent individuals consisting of a group of 39 close contacts with an index case of TB.Results: In patients under anti-TNFa treatment, 28/54 (52%) were ICCFC ESAT-6 (+), compared with QFN-G-IT (+) who were 3.7% (p<0.0001), and Mantoux positive who were 15% (p<0.0001). Additionally, 35/54 (65%) were ICCFC PPD (+) (p<0.0001 in comparison with QFN-G-IT (+) and p<0.0001 in comparison with Mantoux positive). In close contacts, 27 were ICCFC ESAT (+) (69%) in comparison with QFN-G-IT (+) who were 41% (p <0.02). 29 were ICCFC PPD (+) (74%) (p=0.0047 vs QFN-G-IT (+)). However, there was no statistical difference between ICCFC and Mantoux. ICCFC indeterminate results were observed in the immunosuppressed (5/54) and in 5 out of 39 immunocompetent patients (p=ns).Conclusion: The performance of ICCFC for the diagnosis of TB infection is better than QFN-G-IT and Mantoux in patients under immunosuppressive treatment and in immunocompetent close contacts. The robustness of ICCFC test is not substantially affected by the administration of immunosuppressive treatment.