1643. A Prospective Longitudinal Study Evaluating the Usefulness of a T cell-based Assay for Latent Tuberculosis Infection in Allogeneic Hematopoietic Stem Cell Transplant Recipients
Session: Poster Abstract Session: Mycobacterial Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C

Background: Some longitudinal studies have shown that interferon-gamma releasing assays (i.e., QuantiFERON-TB In-Tube [QFT-TB]) are useful to diagnose latent tuberculosis infection (LTBI) especially in contact persons with active tuberculosis (TB). However, there are limited data on predicting subsequent active TB in hematopoietic stem cell transplant (HCT) recipients in whom the ability of tuberculin skin test (TST) to diagnose LTBI is suboptimal. We performed a prospective longitudinal study to evaluate whether QFT-TB assay can predict active TB development in HCT recipients.

Methods: We prospectively enrolled all adult patients admitted for allogeneic HCT between January 2010 and December 2012 at a tertiary hospital in an intermediate TB-burden country. All patients underwent the QFT-TB assay, and patients enrolled between January 2010 and January 2012 received the TST. We observed the development of active TB after HCT between January 2010 and March 2013.

Results: Total 409 HCT recipients were enrolled during a study period. The detailed study profile and results are shown in Figure1. Of the 391 patients, 8 (2%) patients developed active TB after HCT. Three (7%) of the 45 patients with positive QFT-TB assay developed active TB after HCT, while 5 (1%) of the 346 patients with negative or indeterminate QFT-TB assay developed active TB after HCT (p = 0.05). Of the 169 patients who underwent both TST and QFT-TB, 5 (3%) patients developed active TB after HCT. None of the 19 patients with positive TST (>= 5 mm) developed TB after HCT. Among the 150 patients with negative TST (< 5 mm), 3 (15%) of the 20 patients with positive QFT-TB assay developed active TB after HCT, while 2 (2%) of the 130 patients with negative or indeterminate QFT-TB assay developed active TB after HCT (p = 0.02).

Conclusion: Positive QFT-TB assay results predict subsequent development of active TB in HCT recipients who cannot be detected for LTBI by TST (NCT01021124).


Yu-Mi Lee, MD1,2, Sang-Oh Lee, MD1, Sang-Ho Choi, MD1, Yang Soo Kim, MD1, June Hee Woo, MD1, Dae-Young Kim, MD3, Jung-Hee Lee, MD, PhD3, Je-Hwan Lee, MD, PhD3, Kyoo-Hyung Lee, MD, PhD3 and Sung-Han Kim, MD1, (1)Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, (2)Department of Infectious Diseases, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea, (3)Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Disclosures:

Y. M. Lee, None

S. O. Lee, None

S. H. Choi, None

Y. S. Kim, None

J. H. Woo, None

D. Y. Kim, None

J. H. Lee, None

J. H. Lee, None

K. H. Lee, None

S. H. Kim, None

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