Clinical Rheumatology

, Volume 31, Issue 11, pp 1567–1575 | Cite as

Serial interferon-γ release assays for screening and monitoring of tuberculosis infection during treatment with biologic agents

  • Rossana Scrivo
  • Ilaria Sauzullo
  • Fabio Mengoni
  • Giancarlo Iaiani
  • Anna Rita Vestri
  • Roberta Priori
  • Elisa Di Filippo
  • Manuela Di Franco
  • Francesca Romana Spinelli
  • Vincenzo Vullo
  • Claudio Maria Mastroianni
  • Guido Valesini
Original Article


Screening for latent tuberculosis infection (LTBI) prior to the prescribing of anti-TNF agents and monitoring for infection during treatment are recommended. The feasibility of novel screening tools, including QuantiFERON-TB Gold In-Tube (QFT-GIT), remains unclear in the setting of immunosuppression. The aim of this study was to evaluate the usefulness of serial QFT-GIT during biologic therapy to assess whether dynamic changes in IFN-γ levels may be helpful in identifying reactivation of LTBI or newly acquired TB. We conducted a prospective study on patient candidates to TNF inhibitors. QFT-GIT was performed at baseline and after 3 and 6 months since biologic onset. A further follow-up period of 6 months was observed. Among patients enrolled (n = 119; F = 69 %; median age = 47 years, range 18–80), 24 had at least 1 risk factor for LTBI. Ninety-six were taking immunosuppressants at the time of TB testing. At baseline, 5 patients displayed positive, 93 negative, and 21 indeterminate QFT-GIT results. We observed QFT-GIT conversions and reversions in 12 patients with LTBI and in 73 without LTBI. QFT-GIT results changed of 28 % at month 3 and of 21 % at month 6; the greatest change was observed in patients with indeterminate results that became negative (15 %; p < 0.02). No TB cases were detected. In conclusion, the routine use of both QFT-GIT and TST at screening seems not to give any advantage in the setting of patients awaiting biologics. In addition, the feasibility of serial QFT-GIT during biologic therapy needs definition since changes in IFN-γ levels may occur without a pathologic connotation.


Anti-TNF QuantiFERON-TB Gold In-Tube Rheumatoid arthritis Tuberculin skin test 





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Copyright information

© Clinical Rheumatology 2012

Authors and Affiliations

  • Rossana Scrivo
    • 1
  • Ilaria Sauzullo
    • 2
  • Fabio Mengoni
    • 2
  • Giancarlo Iaiani
    • 2
  • Anna Rita Vestri
    • 2
  • Roberta Priori
    • 1
  • Elisa Di Filippo
    • 2
  • Manuela Di Franco
    • 1
  • Francesca Romana Spinelli
    • 1
  • Vincenzo Vullo
    • 2
  • Claudio Maria Mastroianni
    • 3
  • Guido Valesini
    • 1
  1. 1.Dipartimento di Medicina Interna e Specialità Mediche, ReumatologiaSapienza Università di RomaRomeItaly
  2. 2.Dipartimento di Sanità Pubblica e Malattie InfettiveSapienza Università di RomaRomeItaly
  3. 3.UOC Malattie Infettive, Fondazione Eleonora Lorillard Spencer CenciSapienza Università di Roma (Polo Pontino)LatinaItaly

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