جستجوی مقالات مرتبط با کلیدواژه « latent tuberculosis infection » در نشریات گروه « پزشکی »

Health care workers (HCWs) are more likely to get latent tuberculosis infection (LTBI) because of the direct contact they may have with patients and carriers. Therefore, this study aimed to assess the prevalence of LTBI in HCWs.

In the present study, we searched from 1st 2010 to the end of 2021 in various databases such as; PubMed, Scopus, Web of sciences, and Google Scholar for studies presented LTBI in HCWS. After applying inclusion and exclusion criteria and quality assessment, obtained data were analyzed by Comprehensive Meta-analysis (CMV) software.

In total, 22 studies met the eligibility criteria to include in the present systematic review and metaanalysis. The combined prevalence of LTBI was reported by 25.9% (95% CI: 19.3-33.7). No publication bias was seen among studies included based on Eger’s regression test (p=0.04).

Our study showed a high prevalence of LTBI in HCWs. Therefore, periodical screening of HCWs with Suitable tests is essential to prevent this high prevalence. According to the results of this systematic review and meta-analysis, the rate of LTBI in Iranian HCWs is high. Therefore, periodical screening and diagnostic tests such as TST are necessary for the timely diagnosis and treatment of these individuals to prevent changing LTBI to an active form of tuberculosis.

Identification of latent tuberculosis (TB) infection is important in kidney transplant candidates. Due to the absence of a gold standard, both tuberculin skin test (TST) and interferon‑gamma release assays (IGRA) are used to screen patients. The aim of this study was to evaluate the agreement of these two tests in patients undergoing renal transplantation.

Two hundred kidney transplant candidates at a referral center in 2014–2017 were included in this study. TST and Quantiferon‑Gold (QFT‑G) tests were performed for all patients before transplantation. In case of a positive result in any of the tests, patients were administered a 9‑month prophylaxis treatment using isoniazid. Cohen’s kappa coefficient (k) test was used to determine the agreement between the two tests.

The mean age of patients was 40.72 ± 18.33. Nine (4.5%) patients had positive TST and 16 (8%) had positive IGRA. Concordance of the two tests was evaluated as medium (κ = 0.44 and P < 0.001). No association was found between the underlying causes of renal failure and skin test positive or IGRA. The tests showed a poor agreement among diabetics, candidates of re‑transplantation, and those who were on dialysis for longer than a year (κ < 0.20).

TST or IGRA can be used to screen TB in kidney transplant candidates with a moderate agreement. However, we suggest using both TST and QFT‑G in diabetics, re‑transplant candidates, and those on dialysis for >1 year.

 The interferon-gamma release assays (IGRAs) are the most important diagnostic approach to Mycobacterium tuberculosis infection diagnosis. However, they cannot discriminate between latent tuberculosis infection (LTBI) and active tuberculosis (TB). Some recent studies suggested that interleukin-2 (IL-2) response to M. tuberculosis could be utilized as a potential biomarker to discriminate active disease from LTBI.

 The current study aimed at evaluating the potential role of IL-2 to detect both active TB and LTBI among household contacts of patients with pulmonary TB in two TB-endemic regions of Iran.

 A total of 650 household contacts of patients with TB were invited to participate in the current study. All subjects were diagnosed on extensive clinical evaluation of active TB and LTBI based on clinical manifestations and laboratory findings. The IGRA test was performed using QuantiFERON®-TB Gold Plus. The serum level of IL-2 was measured using the ELISA Development Kit.

 A total of 237 household contacts entered the final analysis, including 132 patients with LTBI and three with active TB. In addition, 14 subjects were included as TB controls and 102 as TB-uninfected controls. The serum level of IL-2 was significantly higher in active TB and LTBI patients than TB-uninfected controls. The ROC curve was plotted between active TB and LTBI, revealing that the cutoff point of 25.5 pg/mL identifies the active form with 88.24% sensitivity and 36.36% specificity.

 The current study indicated that the IL-2 assay could not discriminate between active TB and LTBI with acceptable sensitivity.