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Active Tuberculosis Incidence and Characteristics in Patients Treated with Tumor Necrosis Factor Antagonists According to Latent Tuberculosis Infection

Authors
 Eun Hye Lee  ;  Young Ae Kang  ;  Ah Young Leem  ;  Moo Suk Park  ;  Young Sam Kim  ;  Se Kyu Kim  ;  Joon Chang  ;  Song Yee Kim 
Citation
 Scientific Reports, Vol.7(1) : 6473, 2017 
Journal Title
 Scientific Reports 
Issue Date
2017
Abstract
This study aimed to determine the incidence and characteristics of active tuberculosis (TB) in patients treated with tumor necrosis factor (TNF) antagonists according to baseline latent tuberculosis infection (LTBI). Data were retrospectively obtained from 702 patients aged ≥20 years treated with TNF antagonists between November 2005 and June 2016 at Severance Hospital, a tertiary referral hospital in Seoul, South Korea. The interferon-gamma release assay (IGRA) with or without a tuberculin skin test (TST) was used to diagnose LTBI. Of the total of 702 patients, LTBI was diagnosed in 255 (36.3%) patients. 23.9% (168/702) had positive IGRA results, and 32.2% (165/512) had positive TST results. Five patients developed active TB after LTBI treatment, and 6 developed TB despite baseline negative LTBI results. After adjustment for age and sex, the standardized TB incidence ratio was 6.01 (95% CI 1.94-14.04) in the LTBI group and 5.14 (95% CI 1.88-11.18) in the baseline negative LTBI group. Clinicians should be aware of the risk of active TB in patients treated with TNF antagonists despite baseline negative LTBI screening results. Regular monitoring and serial tests should be considered during long-term TNF antagonist therapy, especially in intermediate to high TB burden country.
Files in This Item:
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DOI
10.1038/s41598-017-06899-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강영애(Kang, Young Ae) ORCID logo https://orcid.org/0000-0002-7783-5271
김세규(Kim, Se Kyu)
김송이(Kim, Song Yee) ORCID logo https://orcid.org/0000-0001-8627-486X
김영삼(Kim, Young Sam) ORCID logo https://orcid.org/0000-0001-9656-8482
박무석(Park, Moo Suk) ORCID logo https://orcid.org/0000-0003-0820-7615
이은혜(Lee, Eun Hye) ORCID logo https://orcid.org/0000-0003-2570-3442
임아영(Leem, Ah Young) ORCID logo https://orcid.org/0000-0001-5165-3704
장준(Chang, Joon) ORCID logo https://orcid.org/0000-0003-4542-6841
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160472
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