The objective of this study is to investigate whether the type of biologics (TNFi or others) or type of rheumatic diseases (RA or AS) influence the conversion rate of initially negative tuberculosis (TB) screening test results. A total of 119 patients with RA or AS who had negative baseline interferon-γ release assay (IGRA) results assessed by QuantiFERON-TB Gold in tube (QTF-GIT) were included. All patients received biologic agents, and rescreening with QTF-GIT was performed after a median of 25.9 months from the baseline test. Clinical characteristics and IFN-γ levels were compared between converters and non-converters. Logistic regression analysis was performed to identify factors associated with positive conversion. IGRA conversion was found in 14 of 119 patients (11.8%). The converters were older (53.4 ± 14.2 vs 44.4 ± 15.5 years, p = 0.040), had higher baseline TB-specific IFN-γ responses (0.105 [0.018-0.205] vs 0.010 [0.000-0.035] IU/ml, p = 0.001) and higher incidence of active TB (14.3% vs 0.0%, p = 0.013). The number of patients with RA or AS was 9 (64.3%) or 5 (35.7%) in converters, and 45 (42.9%) or 60 (57.1%) in non-converters. In terms of use of biologics, TNFi of monoclonal antibody form was less commonly used in the converters (p = 0.024). In the logistic regression analysis, type of disease and type of biologics used were not associated with IGRA conversion, whereas baseline TB-specific IFN-γ response was significantly associated with IGRA conversion (OR 1.083, 95% CI 1.019-1.151, p = 0.011). Serial monitoring of LTBI with IGRA retesting is needed during biologic treatment, regardless of the type of rheumatic diseases or type biologics used.

中文翻译：

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生物制剂治疗的风湿病患者中干扰素-γ释放测定的阳性转化。

这项研究的目的是调查生物制剂的类型（TNFi或其他）或风湿性疾病的类型（RA或AS）是否会影响最初的阴性结核病（TB）筛查测试结果的转化率。总共纳入了119例RA或AS患者，这些患者通过QuantiFERON-TB套管中金（QTF-GIT）评估的基线干扰素-γ释放试验（IGRA）结果阴性。所有患者均接受了生物制剂治疗，并且在距基线测试中位数25.9个月后进行了QTF-GIT的重新筛查。比较转化者和非转化者的临床特征和IFN-γ水平。进行逻辑回归分析以鉴定与阳性转化相关的因素。119例患者中有14例（11.8％）发生了IGRA转换。转化者年龄较大（53.4±14.2 vs 44.4±15.5年，p = 0.040），具有较高的基线结核特异性IFN-γ反应（0.105 [0.018-0.205]相对于0.010 [0.000-0.035] IU / ml，p = 0.001）和活动性结核的发生率较高（14.3％vs 0.0％，p = 0.013）。转化者中RA或AS患者的数量为9（64.3％）或5（35.7％），非转化者中为45（42.9％）或60（57.1％）。就生物制剂的使用而言，单克隆抗体形式的TNFi在转化器中使用较少（p = 0.024）。在逻辑回归分析中，使用的疾病类型和生物制剂类型与IGRA转换无关，而基线结核病特异性IFN-γ反应与IGRA转换显着相关（OR 1.083，95％CI 1.019-1.151，p = 0.011 ）。在生物治疗期间，无论风湿性疾病的类型或所用生物制剂的类型如何，都需要通过IGRA重新测试对LTBI进行连续监测。