Open AccessConversion of Tuberculosis Screening Tests During Biologic Therapy Among Veteran Patient Population With Rheumatic Disease
Author(s) -
Pattanaik Debendra,
Gupta Sandeep,
Islam Syed,
Singhal Kunal,
Raza Syed
Publication year - 2019
Publication title -
acr open rheumatology
Language(s) - English
Resource type - Journals
ISSN - 2578-5745
DOI - 10.1002/acr2.11070
Subject(s) - medicine , tuberculin , tuberculosis , seroconversion , population , history of tuberculosis , latent tuberculosis , isoniazid , disease , immunology , pediatrics , mycobacterium tuberculosis , human immunodeficiency virus (hiv) , pathology , environmental health
Objective The optimal strategy to detect the development of tuberculosis ( TB) in subjects receiving biologic agents is not clear. The recommendations vary because there is wide variation in the reported rate of seroconversion in various parts of the world. There is a scarcity of long‐term studies regarding seroconversion of TB in the United States among these patients. Methods This is a retrospective study among veteran populations with rheumatic diseases who received various biologic agents between 2003 and 2014. Subjects who had repeated TB screening tests and adequate follow‐up periods were considered for the study. Results Out of 298 subjects who received biologic agents, 123 were considered for the study. After the initial negative screening test by tuberculin skin test (TST), patients were screened on an average of 1.2 years for 4.3 to 12 years. A total of 420 tests were performed, which were combination of TST and QuantiFERON‐TB gold in‐Tube assay. Only 1 out of 123 subjects (0.8%) seroconverted to latent TB and was treated with isoniazid for 9 months. Conclusion Our results are in line with a few other studies reported from the United States. We conclude that in areas with low prevalence of TB the seroconversion rate is extremely low and annual testing is unnecessary in low‐risk patient populations.