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Evaluation of performance of quantiferon assay and tuberculin skin test in end stage renal disease patients receiving hemodialysis.

PURPOSE
End stage renal disease (ESRD) cases are associated with increased risk of tuberculosis. There is no gold standard method for detecting latent tuberculosis infection (LTBI) in ESRD. The aim of the present study was to analyze the performance of the tuberculin skin test (TST) and QuantiFERON-TB Gold in tube (QFT-G) in cases receiving hemodialysis (HD).


METHODS
The TST and QFT-G were prospectively performed in 96 ESRD cases undergoing HD. The agreement of the QFT-G and TST was assessed in two TST cut off values (10 mm and 5 mm) in Bacille Calmette Guèrin (BCG) vaccinated and non-vaccinated cases.


RESULTS
Of 96 cases 67 were BCG vaccinated and 29 were BCG non-vaccinated. QFT-G was positive in 39.6% cases and indeterminate in 3.1%. TST was positive in 43.8% of cases in cut off value of 10 mm and positive in 58.3% of cases in cut off value of 5 mm. Agreement between TST and QFT-G results was fair in both BCG vaccinated and non-vaccinated cases in either cut off values, except in cut off value of 10 mm in BCG vaccinated cases in which the agreement was moderate.


CONCLUSION
The agreement between QFT-G and TST test is fair and there is no significant difference in both cut off values of TST in screening of LTBI in ESRD cases receiving HD.