• Rheumatol. Int. · Nov 2009

    Comparative Study

    Evaluation of an interferon gamma assay in the diagnosis of latent tuberculosis infection in patients with rheumatoid arthritis.

    • Cláudia Diniz Lopes Marques, Ângela Luzia Branco Pinto Duarte, Virginia Maria Barros de Lorena, Joelma Rodrigues Souza, Wayner Vieira Souza, Yara de Miranda Gomes, and Eduardo Maia Freese de Carvalho.
    • Escola Pernambucana de Medicina, FBV/IMIP, Rua dos Coelhos, 300 Recife, PE CEP 50070-550, Brazil. claudia_reumatologia@terra.com.br
    • Rheumatol. Int. 2009 Nov 1; 30 (1): 57-62.

    AbstractThe tuberculin skin test is not an ideal screening test for the patients with rheumatoid arthritis to identify cases of latent tuberculosis infection (LTBI) prior to the start of treatment with anti-TNFs, as it responds inadequately to late hypersensitivity, which is fundamental for producing a response to the inoculated antigen. Assays based on detection of the production of IFNγ in vitro by mononuclear peripheral cells stimulated by specific antigens are more specific than PPD in detecting LTBI. The aim of this study was to evaluate the performance of T-SPOT.TB in diagnosis of LTBI in patients with rheumatoid arthritis, comparing with the PPD. The specificity of the T-SPOT.TB varied from 87 to 90% and the negative-predictive value (NPV) from 94.4 to 100%. It can be concluded that the T-SPOT.TB showed high specificity and NPV, proving the capability of identifying false-negative cases of PPD, raising the level of safety for the use of anti-TNFs.

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