ackground Tuberculosis (TB) remains an important cause
of morbidity and mortality in hemodialysis (HD) patients. A
gold standard for the diagnosis of latent tuberculosis infection
(LTBI) is lacking.
Objective The aim of this study was to compare the
diagnostic utility of the QuantiFERON-Tuberculosis Gold
(QFT-G) test with the tuberculin skin test (TST) in identifying
LTBI in patients with end-stage renal disease (ESRD) on HD.
Study design The present study had a prospective design.
Patients and methods A total of 74 patients with ESRD on
HD without active TB and other immunosuppressive
conditions were tested for LTBI by the QFT-G test and the
TST.
Results LTBI, as estimated by the QFT-G test and TST, was
detected in 35.1 and 13.5% of the HD patients, respectively;
37.8% of patients were positive for the QFT-G test and/or the
TST. There was a poor agreement between QFT-G test and
TST results in patients with ESRD on HD (QFT-G test vs.
TST: κ=0.25, 95% confidence interval=0.12–0.37). TST was
positive in 2.7% of patients when the QFT-G test was
negative, and it was negative in 24.3% of patients when the
QFT-G test was positive. There was no significant difference
in duration of HD or creatinine levels between QFT-G-positive
and QFT-G-negative patients (P=0.08 and 0.2, respectively).
TST-positive patients had a significantly shorter duration of
HD and lower creatinine levels than TST-negative patients
(P=0.001 and 0.01, respectively).
Conclusion In patients with ESRD and on HD, LTBI cannot
be simply ruled out with a negative TST result, but rather a
QFT-G test is recommended. Screening and treatment of
LTBI should be carried in dialysis patients, aiming to prevent