TY - JOUR
T1 - Spotlight on latent tuberculosis infection screening for juvenile idiopathic arthritis in two countries, comparing high and low risk patients
AU - Piotto, Daniela
AU - Nicacio, Aline
AU - Neto, Agna
AU - Mourão, Ana Filipa
AU - Oliveira-Ramos, Filipa
AU - Campanilho-Marques, Raquel
AU - Guedes, Margarida
AU - Cabral, Marta
AU - Santos, Maria José
AU - Fonseca, João Eurico
AU - Canhão, Helena
AU - Aikawa, Nádia Emi
AU - Oliveira, Sheila K F
AU - Ferriani, Virginia P L
AU - Pileggi, Gecilmara C S
AU - Magalhães, Claudia S
AU - Silva, Clovis Artur
AU - Terreri, Maria Teresa
N1 - © 2022. The Author(s).
PY - 2022/6/10
Y1 - 2022/6/10
N2 - BACKGROUND: Rheumatic diseases are associated with an increase in overall risks of tuberculosis (TB). The aim of this study was to evaluate the frequency of TB and the frequency of latent TB infection (LTBI), in clinical practice, for juvenile idiopathic arthritis (JIA) patients from high and low risk of TB incidence endemic countries.METHODS: This is an international, multicenter, cross-sectional, observational study of data collection from Brazil and Registry of Portugal at REUMA.PT. The inclusion criteria were patients with Juvenile Idiopathic Arthritis (JIA) with age ≤ 18 years who underwent screening for Mycobacterium tuberculosis infection [tuberculin skin test (TST) and/or interferon gamma release assay (IGRA)]. Chest X-rays and history of exposure to TB were also assessed.RESULTS: 292 JIA patients were included; mean age 14.3 years, mean disease duration 7.5 years, 194 patients (66.4%) performed only TST, 14 (4.8%) only IGRA and 84 (28.8%) both. The frequency of LTBI (10.6%) and TB was similar between the two countries. The reasons for TB screening were different; in Brazil it was performed more often at JIA onset while in Portugal it was performed when starting Disease Modified Anti-Rheumatic Drugs (DMARD) treatment (p < 0.001). Isoniazid therapy was prescribed in 40 (13.7%) patients (31 with LTBI and 9 with epidemiologic risks and/or due to contact with sick people). Only three patients (1%) developed active TB.CONCLUSION: We found nearly 10% of patients with LTBI, a small percentage of patients with treatment due to epidemiologic risks and only 1% with active TB. Distinct reasons and screening methods for LTBI were observed between the two countries.
AB - BACKGROUND: Rheumatic diseases are associated with an increase in overall risks of tuberculosis (TB). The aim of this study was to evaluate the frequency of TB and the frequency of latent TB infection (LTBI), in clinical practice, for juvenile idiopathic arthritis (JIA) patients from high and low risk of TB incidence endemic countries.METHODS: This is an international, multicenter, cross-sectional, observational study of data collection from Brazil and Registry of Portugal at REUMA.PT. The inclusion criteria were patients with Juvenile Idiopathic Arthritis (JIA) with age ≤ 18 years who underwent screening for Mycobacterium tuberculosis infection [tuberculin skin test (TST) and/or interferon gamma release assay (IGRA)]. Chest X-rays and history of exposure to TB were also assessed.RESULTS: 292 JIA patients were included; mean age 14.3 years, mean disease duration 7.5 years, 194 patients (66.4%) performed only TST, 14 (4.8%) only IGRA and 84 (28.8%) both. The frequency of LTBI (10.6%) and TB was similar between the two countries. The reasons for TB screening were different; in Brazil it was performed more often at JIA onset while in Portugal it was performed when starting Disease Modified Anti-Rheumatic Drugs (DMARD) treatment (p < 0.001). Isoniazid therapy was prescribed in 40 (13.7%) patients (31 with LTBI and 9 with epidemiologic risks and/or due to contact with sick people). Only three patients (1%) developed active TB.CONCLUSION: We found nearly 10% of patients with LTBI, a small percentage of patients with treatment due to epidemiologic risks and only 1% with active TB. Distinct reasons and screening methods for LTBI were observed between the two countries.
KW - Adolescent
KW - Antirheumatic Agents/therapeutic use
KW - Arthritis, Juvenile/complications
KW - Cross-Sectional Studies
KW - Humans
KW - Interferon-gamma Release Tests/methods
KW - Latent Tuberculosis/diagnosis
KW - Tuberculin Test/methods
U2 - 10.1186/s42358-022-00251-6
DO - 10.1186/s42358-022-00251-6
M3 - Article
C2 - 35689240
SN - 2523-3106
VL - 62
JO - Advances in rheumatology (London, England)
JF - Advances in rheumatology (London, England)
IS - 1
M1 - 20
ER -