| dc.description.abstract | Introduction: Tuberculosis (TB) is common in patients with chronic renal failure due to their immunosuppressed
state. Diagnosing TB is difficult because of the latency of the clinical and biological picture. This study was
conducted to assess the performance of the Interferon Gamma Released Assay (IGRA) in the diagnosis of latent TB
infection in chronic dialysis patients in Senegal.
Materials and methods: This is a cross-sectional study carried out in Nephrology Department of Aristide Le
Dantec University Hospital during 6 month. All patients with chronic haemodialysis or chronic peritoneal dialysis
were included. A group of patients with non-dialyzed kidney disease was also included. Patients with active TB at
the time of the study were not included. A tuberculin skin test (TST) and an IGRA were performed. The
QuantiFERON® (QFT) was repeated 3 months later in the group of dialysis patients.
Results: Sixty-two patients were included: 22 haemodialysis (HD) patients, 19 peritoneal dialysis (PD) patients
and 21 patients with non-dialyzed kidney disease (NDKD). The mean age was 44 ± 12 years with a sex ratio M/F of
1.06. Nineteen patients were vaccinated with BCG. TST was positive in 22 patients (35.4%). Subjects with a positive
TST had a significantly higher rate of BCG vaccination (P=0.002) than those with a negative TST. QFT was positive
in 17 patients (28%) and undetermined in 9 patients (14%). In patients with a positive QFT, six (27%) were in HD,
four (21%) in peritoneal dialysis and seven (33%) in NDKD. A total of 9/17 (52%) QFT-positive patients developed
active TB. Correlation (r=0.998, p=0.001) indicates that T cell functionality was not affected by the duration of renal
replacement therapy.
Conclusion: These results highlight the advantage of Quantiferon test over TST for diagnosis of latent TB in
immunocompromised patients, including chronic dialysis patients. | en_US |
