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Experience with the use of Quantiferon test, a novel method to detect tuberculosis, in two arthritis centers in Budapest, Hungary
István Á. Juhász1, Judit Korda2, Bernadette Rojkovich1
1Polyclinic of the Hospitaller Brothers of St. John of God, 2National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
Because the immunosuppressive effect of biological treatments is well known the early recognition of infection is of utmost importance for arthritis centers administering biological therapies. TB occupies a prominent place among the adverse effects of TNFalpha inhibitors and several diagnostic procedures exist for its detection. Although culture is the most definitive test, it takes too much time. Intracutan tuberculin test with purified protein derivate (PPD) requires less time, however it is not specific for human pathogen Mycobacteria and it gives positive reaction in patients immunized with Bacillus Calmette-Guérin (BCG).
Discrimination between BCG vaccination and tuberculosis infection is possible using the gamma-interferon (Quantiferon) test that is less time consuming but more expensive than PPD. The experience gained during the use of Quantiferon test in the setting of biological therapy in two arthritis centers in Budapest is presented. The authors analyze the collected results of this recently introduced test on a limited number of patients, taking into account the immunosuppressive effects of co-medication, and give their opinion during a case presentation of a 50-year-old man with SPA treated with infliximab who developed TB and was diagnosed with the use of Quantiferon test.
