Evidence map›Paper›PMID 30673986›Full record

ArticleDigestive diseases and sciences2019

Superiority of Interferon Gamma Assay Over Tuberculin Skin Test for Latent Tuberculosis in Inflammatory Bowel Disease Patients in Brazil.

Renata F Amorim, Eduardo R C Viegas, Antonio José V Carneiro, Barbara C Esberard, Evelyn S Chinem, Raquel S Correa, Luciana Rodrigues, Marcelo Ribeiro-Alves, Kelly S Silva, Heitor S de Souza and 1 more

Abstract readComparative Study
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In one paragraph

Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Renata F AmorimDepartment of Gastroenterology, The State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Eduardo R C ViegasDepartment of Gastroenterology, The State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Antonio José V CarneiroDepartment of Internal Medicine, Division of Gastroenterology, The Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Ilha do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil.
Barbara C EsberardDepartment of Gastroenterology, The State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Evelyn S ChinemDepartment of Gastroenterology, The State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Raquel S CorreaImmunopathology Laboratory, The State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Luciana RodriguesImmunopathology Laboratory, The State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Marcelo Ribeiro-AlvesEvandro Chagas National Institute of Infectology, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
Kelly S SilvaDepartment of Gastroenterology, The State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Heitor S de SouzaDepartment of Internal Medicine, Division of Gastroenterology, The Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Ilha do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil. heitor.souza@gmail.com.ORCID http://orcid.org/0000-0002-3647-7324
Ana Teresa P CarvalhoDepartment of Gastroenterology, The State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsTo compare tuberculin skin test (TST) and interferon gamma release assay (IGRA) in the screening of LTBI among patients with inflammatory bowel disease (IBD) in an endemic area for tuberculosis, to evaluate the need for repeating tests during anti-TNFα, therapy, and to check whether the results may be affected by immunosuppression.

methodsA cross-sectional study of 110 IBD patients and 64 controls was conducted in Rio de Janeiro, Brazil. The TST was administered after the Quantiferon(

resultsTST and IGRA agreement was poor regarding diagnosis (kappa: control = 0.318; UC = 0.202; and CD = - 0.093), anti-TNFα therapy (kappa: with anti-TNFα = 0.150; w/o anti-TNFα = - 0.123), and immunosuppressive therapy (IST) (kappa: with IS = - 0.088; w/o IS = 0.146). Indeterminate IGRA was reported in four CD patients on IST. Follow-up tests after anti-TNFα identified conversion in 8.62% using TST and 20.0% using IGRA. Considering IGRA as a criterion standard, TST showed low sensitivity (19.05%) and positive predictive value (PPV) (21.05%). LTBI detection remarkably improved when IGRA was added to TST (sensitivity of 80.95% and PPV of 53.13%). Results were particularly relevant among CD patients where rates started from zero to reach sensitivity and PPV of more than 60%.

conclusionIGRA alone was more effective to detect LTBI than TST alone and had an overall remarkable added value as an add-on sequential test, particularly in CD patients. While cost-effectiveness of these strategies remains to be evaluated, IGRA appears to be justified in CD prior to and during anti-TNFα therapy, where tuberculosis is endemic.

Indexed as

Interferon-gamma Release TestsTuberculin TestAdultAgedBiological ProductsBrazilCross-Sectional StudiesFemaleHumansImmunocompromised HostImmunosuppressive AgentsInflammatory Bowel DiseasesLatent TuberculosisMaleMiddle AgedPredictive Value of TestsBiological ProductsImmunosuppressive AgentsTNF protein, humanTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsInflammatory bowel diseaseInterferon gamma release assayLatent tuberculosis infectionTuberculin skin test

Identifiers

PMID30673986

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.