Interferon-gamma release assays versus tuberculin skin testing in patients with rheumatoid arthritis
Article first published online: 8 JUN 2013
© 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd
International Journal of Rheumatic Diseases
Volume 16, Issue 3, pages 279–283, June 2013
How to Cite
Song, G. G., Bae, S.-C. and Lee, Y. H. (2013), Interferon-gamma release assays versus tuberculin skin testing in patients with rheumatoid arthritis. International Journal of Rheumatic Diseases, 16: 279–283. doi: 10.1111/1756-185X.12098
- Issue published online: 11 AUG 2013
- Article first published online: 8 JUN 2013
- Korean Ministry of Health and Welfare
- Korean Healthcare Technology R&D Project. Grant Number: A102065
- interferon-gamma release assays;
- rheumatoid arthritis;
- tuberculin skin tests
The aim of this study was to analyze the results of interferon-gamma release assays (IGRAs) and tuberculin skin tests (TST) performed to detect latent tuberculosis infection (LTBI) in patients with rheumatoid arthritis (RA).
Interferon-γ release assays and TST test results were summarized and systematically reviewed.
Four hundred and five RA patients and 339 controls that underwent IGRA and/or TST were identified in seven studies. Five studies were case-control studies and two were cross-sectional studies. Among RA patients, the IGRA positivity rate was 31.6% (89/282; range 11.4%–44.6%), and the TST positivity rate was 23.0% (78/339; range from 14.60% to 45%). Concordance rates ranged from 40% to 76% and discordance rates from 24% to 29.7%. Agreement between IGRAs and TST in RA was poor (69.6%, k = 0.33, 95% CI 0.188–0.478). The IGRA positivity rate was 31.0% in RA and 40.0% in controls, which was not significant (relative risk [RR] 0.802, 95% CI 0.629–1.023, P = 0.075). The TST positivity rate was 24.7% in RA and 50.5% in controls, and this difference was not significant (RR 0.680, 95% CI 0.331–1.339, P = 0.295).
Positivity rates of IGRA and TST were 31.6 and 23.0%, respectively, in RA patients. Agreement between IGRA and TST results in RA was poor. Our data suggest that both IGRA and TST are needed to detect LTBI in RA.