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Usefulness of the QuantiFERON test for the diagnosis of tubercular uveitis and the predictions of response to antituberculosis treatment
British Journal of Ophthalmology ( IF 3.7 ) Pub Date : 2023-04-01 , DOI: 10.1136/bjophthalmol-2021-318868
William Danjou 1 , Pierre Pradat 2 , Yvan Jamilloux 1 , Mathieu Gerfaud-Valentin 1 , Laurent Kodjikian 3 , Salim Trad 4 , Pascal Seve 5, 6
Affiliation  

Aims Few studies have evaluated the contribution of QuantiFERON test for the diagnosis of tubercular uveitis in non-endemic countries for tuberculosis (TB). The objective of the present study was to evaluate the value of the QuantiFERON test in a large cohort of patients with uveitis for both the diagnosis of tubercular uveitis and antituberculosis treatment (ATT) response prediction. Methods A single-centre retrospective study including consecutive adult patients with uveitis who were prescribed a QuantiFERON test between January 2003 and December 2019 was performed. Adjusted ORs (aORs) were calculated between patients with uveitis responding and not responding to ATT according to the Collaborative Ocular Tuberculosis Study (COTS) group diagnostic criteria. Sensitivity (SE), specificity (Sp), and positive and negative predictive values of the QuantiFERON test were calculated. Results A total of 1075 patients were included in the study; 178 (16.5%) were found positive using the QuantiFERON test. Among the 178 positive patients, 62 (35%) had a diagnosis of tubercular uveitis according to the updated COTS classification; all received ATT for 6 months; and 44/62 (71%) responded to ATT. A QuantiFERON test value of >2 IU/mL was associated with a greater chance of responding to ATT (aOR=36.7, 95% CI 7.2 to 185.9, p<0.001). The optimal threshold to maximise both Sp and SE for diagnosis of TB uveitis was 4 IU/mL. Conclusion One-sixth of the patients diagnosed with uveitis had a positive QuantiFERON test. The QuantiFERON threshold with the optimal SE and Sp for the diagnosis of tubercular uveitis was 4 IU/mL. Trial registration number [NCT03863782][1]. No data are available. All free text entered below will be published. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03863782&atom=%2Fbjophthalmol%2F107%2F4%2F500.atom

中文翻译:

QuantiFERON 测试对结核性葡萄膜炎诊断的有用性以及对抗结核治疗反应的预测

目的 很少有研究评估 QuantiFERON 测试对非结核病 (TB) 流行国家结核性葡萄膜炎诊断的贡献。本研究的目的是评估 QuantiFERON 试验在大量葡萄膜炎患者中对结核性葡萄膜炎的诊断和抗结核治疗 (ATT) 反应预测的价值。方法 进行了一项单中心回顾性研究,纳入了 2003 年 1 月至 2019 年 12 月期间接受 QuantiFERON 测试的连续成年葡萄膜炎患者。根据协作性眼结核研究 (COTS) 组诊断标准,计算对 ATT 有反应和无反应的葡萄膜炎患者的调整后 OR (aOR)。灵敏度(SE),特异性(Sp),并计算了 QuantiFERON 测试的阳性和阴性预测值。结果本研究共纳入1075例患者;使用 QuantiFERON 测试发现 178 人 (16.5%) 呈阳性。在 178 名阳性患者中,62 名 (35%) 根据更新的 COTS 分类诊断为结核性葡萄膜炎;所有人都收到了 6 个月的 ATT;44/62 (71%) 回应了 ATT。>2 IU/mL 的 QuantiFERON 测试值与更大的 ATT 响应机会相关(aOR=36.7,95% CI 7.2 至 185.9,p<0.001)。用于诊断结核性葡萄膜炎的 Sp 和 SE 最大化的最佳阈值是 4 IU/mL。结论 六分之一诊断为葡萄膜炎的患者的 QuantiFERON 检测呈阳性。用于诊断结核性葡萄膜炎的具有最佳 SE 和 Sp 的 QuantiFERON 阈值为 4 IU/mL。试用注册号[NCT03863782][1]。没有可用数据。下面输入的所有自由文本都将发布。[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03863782&atom=%2Fbjophthalmol%2F107%2F4%2F500.atom
更新日期:2023-03-22
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