PT  - JOURNAL ARTICLE
AU  - Jérémie Sellam
AU  - Haifa Hamdi
AU  - Carine Roy
AU  - Gabriel Baron
AU  - Marc Lemann
AU  - Xavier Puéchal
AU  - Maxime Breban
AU  - Francis Berenbaum
AU  - Marc Humbert
AU  - Karin Weldingh
AU  - Dominique Salmon
AU  - Philippe Ravaud
AU  - Dominique Emilie
AU  - Xavier Mariette
TI  - Comparison of in vitro-specific blood tests with tuberculin skin test for diagnosis of latent tuberculosis before anti-TNF therapy
AID  - 10.1136/ard.2007.069799
DP  - 2007 Dec 01
TA  - Annals of the Rheumatic Diseases
PG  - 1610--1615
VI  - 66
IP  - 12
4099  - http://ard.bmj.com/content/66/12/1610.short
4100  - http://ard.bmj.com/content/66/12/1610.full
SO  - Ann Rheum Dis2007 Dec 01; 66
AB  - Introduction: Latent tuberculosis infection (LTBI) is detected with the tuberculin skin test (TST) before anti-TNF therapy. We aimed to investigate in vitro blood assays with TB-specific antigens (CFP-10, ESAT-6), in immune-mediated inflammatory diseases (IMID) for LTBI screening.Patients and methods: Sixty-eight IMID patients with (n = 35) or without (n = 33) LTBI according to clinico-radiographic findings or TST results (10 mm cutoff value) underwent cell proliferation assessed by thymidine incorporation and PKH-26 dilution assays, and IFNγ-release enzyme-linked immunosorbent spot (ELISPOT) assays with TB-specific antigens.Results: In vitro blood assays gave higher positive results in patients with LTBI than without (p<0.05), with some variations between tests. Among the 13 patients with LTBI diagnosed independently of TST results, 5 had a negative TST (38.5%) and only 2 a negative blood assays result (15.4%). The 5 LTBI patients with negative TST results all had positive blood assays results. Ten patients without LTBI but with intermediate TST results (6–10 mm) had no different result than patients with TST result ⩽5 mm (p>0.3) and lower results than those with LTBI (p<0.05) on CFP-10+ESAT-6 ELISPOT and CFP-10 proliferation assays.Conclusion: Anti-TB blood assays are beneficial for LTBI diagnosis in IMID. Compared with TST, they show a better sensitivity, as seen by positive results in 5 patients with certain LTBI and negative TST, and better specificity, as seen by negative results in most patients with intermediate TST as the only criteria of LTBI. In the absence of clinico-radiographic findings for LTBI, blood assays could replace TST for antibiotherapy decision before anti-TNF.