FRI0033 QUANTIFERON GOLD-PLUS AND TUBERCULIN SKIN TEST REACTIVITY PREDICTORS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Juan Pablo Carrizales-Luna,Dionicio Ángel Galarza-Delgado, Luis Adrián Rendón-Pérez,Griselda Serna-Peña,Gisela García-Arellano, Mayra Alexandra Rendón-Medina,Berenice Soto-Monciváis,Leticia Santoyo-Fexas, Juan Manuel Muñoz-Ayala

ANNALS OF THE RHEUMATIC DISEASES(2019)

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摘要
Background: RA patients have high latent tuberculosis(LTBI)prevalence(20-37%)1. In Mexico,ranges from 21.7% to 31.3% using tuberculin skin test (TST)2. The methods to detect LTBI are TST and IGRAs. QuantiFERON Gold-Plus (QTF-Plus)uses an antigen tube (TB1) that stimulates CD4+T cells and an additional tube (TB2) that also stimulates CD8+T cells3. Objectives: Determine the LTBI prevalence,variables that predict QTF-Plus and TST results and the concordance between TST and QTF-Plus in RA patients. Methods: A cross-sectional study in RA patients from the rheumatology department of the University Hospital “Jose E. Gonzalez” in Mexico between October 2017 and June 2018. RA patients with ACR/EULAR 2010 classification criteria without a history of tuberculosis (TB) were included.QFT-Plus was performed according to manufacturer instructions.TST was applied with the Mantoux technique; a ≥5mm cutoff was used.The square chi and Fisher test were used for proportions, Mann-Whitney to compare means,trend analysis using linear trend test and a binary logistic regression model for variables related to positivity to both tests. Results: We included 111 patients (table 1), the mean age was 51.9 years, 92.3% were women,disease duration 8.7±8.8 years. QTF-Plus was positive in 46 (44.6%) patients. TST was positive in 31(27.9%) patients.Agreement between tests was 73.7% (kappa=0.45, p Conclusion: The LTBI prevalence in RA patients in our study is similar to countries with a high TB burden.We recommend considering RA patients as a high-risk population for LTBI.An intermediate agreement between TST and QTF-Plus was found.The use of antimalarials and ≥2DMARDs influence the TST reactivity,none of the variables altered the QTF-Plus results.Based on the results, we recommend the QuantiFERON Gold Plus over TST for the LTBI screening in RA patients. References: [1] Sester M,et al.Am J Respir Crit Care Med.2014;190(10):1168–76. [2] Perez-Barbosa L,et al.Rheumatol Int.2015;35(9):1555–9. [3] Takasaki J,et al.J Infect Chemother.2018;24(3):188–92. Disclosure of Interests: None declared
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rheumatoid arthritis,gold-plus
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