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Background Tuberculosis (TB) remains an important cause of morbidity and mortality in hemodialysis (HD) patients. A gold standard for the diagnosis of latent tuberculosis infection (LTBI) is lacking. Objective The aim of this study was to compare the diagnostic utility of the QuantiFERON-Tuberculosis Gold (QFT-G) test with the tuberculin skin test (TST) in identifying LTBI in patients with end-stage renal disease (ESRD) on HD. Study design The present study had a prospective design. Patients and methods A total of 74 patients with ESRD on HD without active TB and other immunosuppressive conditions were tested for LTBI by the QFT-G test and the TST. Results LTBI, as estimated by the QFT-G test and TST, was detected in 35.1 and 13.5% of the HD patients, respectively; 37.8% of patients were positive for the QFT-G test and/or the TST. There was a poor agreement between QFT-G test and TST results in patients with ESRD on HD (QFT-G test vs. TST: κ=0.25, 95% confidence interval=0.12–0.37). TST was positive in 2.7% of patients when the QFT-G test was negative, and it was negative in 24.3% of patients when the QFT-G test was positive. There was no significant difference in duration of HD or creatinine levels between QFT-G-positive and QFT-G-negative patients (P=0.08 and 0.2, respectively). TST-positive patients had a significantly shorter duration of HD and lower creatinine levels than TST-negative patients (P=0.001 and 0.01, respectively). Conclusion In patients with ESRD and on HD, LTBI cannot be simply ruled out with a negative TST result, but rather a QFT-G test is recommended. Screening and treatment of LTBI should be carried in dialysis patients, aiming to prevent progression to active TB and secondary infection of others.

the egyptian journal of bronchology

Detection of latent tuberculosis infection in hemodialysis patients: Comparison between the quantiferon-tuberculosis gold test and the tuberculin skin test