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Tuberculosis screening using IGRA and chest computed tomography in patients with inflammatory bowel disease: A retrospective study
Author(s) -
Song Dong Juan,
Tong Jin Lu,
Peng Jiang Chen,
Cai Chen Wen,
Xu Xi Tao,
Zhu Ming Ming,
Ran Zhi Hua,
Zheng Qing
Publication year - 2017
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12437
Subject(s) - medicine , inflammatory bowel disease , tuberculosis , computed tomography , retrospective cohort study , radiology , disease , gastroenterology , pathology
Objectives To assess the prevalence and potential risk factors of latent tuberculosis infection ( LTBI ) in Chinese patients with inflammatory bowel disease ( IBD ) and to evaluate the role of chest computed tomography ( CT ) in the screening of LTBI . Methods A single‐center retrospective study was conducted and all IBD patients who had been screened for LTBI by T‐SPOT . TB between December 2011 and January 2016 were enrolled in the study. Both inpatient and outpatient records were collected and comprehensively reviewed. Results Altogether 534 IBD patients were included. The positivity rate of T‐SPOT . TB was 18.0% overall, 31.9% in IBD unclassified, 22.5% in ulcerative colitis and 13.0% in Crohn's disease patients, respectively. Age, history of TB and the administration of immunosuppressants were significantly associated with T‐SPOT . TB positivity. Among 123 patients who underwent serial testing, the conversion and reversion rate of T‐SPOT.TB was 10.2% and 42.9%, respectively. Furthermore, 102 of 447 (22.8%) patients who underwent chest computed tomography ( CT) were found with abnormal CT findings suggestive of LTBI . The concordance rate was 75% between the T‐SPOT.TB and chest CT with a kappa value of 0.25 (95% CI 0.15–0.35). Conclusions The prevalence of LTBI in IBD patients is high in China. Chest CT is recommended as an alternative to IGRA for screening LTBI of IBD patients before commencing immunosuppressive therapy in high‐prevalence regions.