Diagnosing latent tuberculosis in immunocompromised patients measuring blood IP-10 production capacity: an analysis of chronic renal failure patients

Intern Med. 2015;54(5):465-72. doi: 10.2169/internalmedicine.54.3245. Epub 2015 Jan 15.

Abstract

Objective: Patients undergoing haemodialysis for chronic renal failure-hemodialysis (CRF-HD) are at risk of latent tuberculosis infection (LTBI). The effectiveness of using blood IP-10 production capacity to diagnose LTBI in CRF-HD patients was analysed.

Methods: The study enrolled 50 CRF-HD patients. Interferon-γ release assay (IGRA) was done using QuantiFERON-TB Gold In Tube (QFG-IT) system. Blood IP-10 production capacity was measured using the QFG-IT system tubes. Tuberculin skin testing (TST) was performed on the same day and the test results were compared.

Results: TST turned out to be positive in 36.4% of the patients and QFG-IT in 54% of them. After stimulation with specific tuberculosis antigens, blood IP-10 levels increased noticeably. The antigen-stimulated blood IP-10 level was significantly higher in patients who were either TST or QFG-IT positive than in patients whose tests were negative (p=0.0001). Using 4.02 pg/mL as the threshold for stimulated blood log-transformed IP-10 level, good agreement was observed between IP-10 and QFG-IT results (κ=1).

Conclusion: Blood IP-10 level, which can be measured simply, provides results equivalent to IGRAs for the diagnosis of LTBI in CRF-HD patients.

MeSH terms

  • Chemokine CXCL10 / biosynthesis*
  • Female
  • Humans
  • Immunocompromised Host*
  • Interferon-gamma
  • Interferon-gamma Release Tests
  • Kidney Failure, Chronic / therapy
  • Latent Tuberculosis / blood*
  • Latent Tuberculosis / diagnosis*
  • Male
  • Middle Aged
  • Renal Dialysis
  • Risk Factors
  • Tuberculin Test

Substances

  • CXCL10 protein, human
  • Chemokine CXCL10
  • Interferon-gamma