Comparison of QuantiFERON-TB Gold and the tuberculin skin test for the detection of previous tuberculosis infection evaluated by chest CT findings in Japanese rheumatoid arthritis patients

Excerpt

The reactivation of previous tuberculosis (TB) infection has become a serious complication of the biological treatment of patients with rheumatoid arthritis (RA) [1]. This study compared the results of two tests for latent tuberculosis infection—an interferon (IFN)-γ release assay [the QuantiFERON-TB Gold test (QFT), Cellestis, Carnegie, Australia] and the tuberculin skin test (TST)—in Japanese patients with RA in whom the history of previous TB infection was assessed with computed tomography (CT) of the chest. The rate for positive results for the QFT was significantly higher in patients with a history of TB infection and significantly lower in patients without infection. Furthermore, the mean diameter of induration with the TST was less in patients with previous TB infection than in patients without infection. Under Japanese guidelines for the treatment of RA, the history of previous TB infection must be assessed by means of interview, the TST, and chest radiography before the administration of biological agents [2]. To avoid unnecessary administration of prophylactic medication, it is recommended that patients with a history of previous TB infection be accurately identified. …