目的:评估QuantiFERON~-TB(QFT)、结核菌素皮肤试验(TST)及两种方法联合(TST+QFT)检测在法国接种过卡介苗(BCG)人群结核潜伏感染(LTBI)的成本效益。方法:建立决策分析模型评估结核(TB)密切接触成人三种检测方案的效果,并计算直接医疗...目的:评估QuantiFERON~-TB(QFT)、结核菌素皮肤试验(TST)及两种方法联合(TST+QFT)检测在法国接种过卡介苗(BCG)人群结核潜伏感染(LTBI)的成本效益。方法:建立决策分析模型评估结核(TB)密切接触成人三种检测方案的效果,并计算直接医疗成本,预期寿命和增量费用-效果比率(incremental cost-effectiveness ratios,ICERs)。结果:每位病人在无检测、TST检测、QFT检测和TST+QFT检测时兑现直接医疗费用分别为417欧元、476欧元、443欧元、435欧元,而兑现预期寿命分别为25.030、25.071、5.073和25.062年。相比QFT,TST的成本较高、效率低;与未检测相比,TST+QFT检测与获得每个生命年(year of life gained,YLG)需560欧元的一个ICER有关。与TST+QFT相比,QFT检测与获得每个生命年需730欧元的一个ICER有关。只有在LTBI率低(<5%)和TST特异性高(>90%)的情况下,QFT与ICER>75 000欧元/YLG有关。结论:在法国,各种诊断结核病密切接触者LTBI的方法中...展开更多
Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including sys...Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.展开更多
Introduction: The objective of this study was the comparison of the results of T-SPOT.TB using pleural effusion (PE) with those of IGRAs using peripheral blood (PB) or other diagnostic methods for the diagnosis of tub...Introduction: The objective of this study was the comparison of the results of T-SPOT.TB using pleural effusion (PE) with those of IGRAs using peripheral blood (PB) or other diagnostic methods for the diagnosis of tuberculous (TB) pleurisy. Methods: We measured adenosine deaminase (ADA) in PE, QuantiFERON TB-Gold In-Tube (QFT), and T-SPOT.TB using PB, and T-SPOT.TB using PE. The definite group of TB pleurisy included 12 patients and other disease group 33 patients. Main find-ings: Sensitivity for QFT using PB was 83% and specificity was 85%, sensitivity for T-SPOT.TB using PB was 92% and specificity was 82%, while sensitivity for ADA in PE was 83% and specificity was 76%. When we adopted the same cut-off level of a positive response for T-SPOT.TB as PB using PE, sensitivity for T-SPOT.TB using PE was 100% and specificity was 82%, respectively. Although there were no significant differences among the four diagnostic methods, sensitivity for T-SPOT.TB using PE gave the most accurate diagnosis of TB-definite patients compared to ADA in PE or QFT using PB. Conclusions: If we performed T-SPOT.TB using a local specimen from the infection site, we could obtain a higher sensitivity than IGRAs using PB or ADA in PE and the numbers of ESAT-6 and CFP-10-positive SFCs were 3 to 5 fold higher in PEMCs than in PBMCs. T-SPOT.TB using PE may become a useful diagnostic method for TB pleurisy.展开更多
Objective:To determine the relationship of the capacity to produce interferon gamma(IFN-γ) in whole blood,bacteriological,hematological,radiographic and clinical presentations in new,HIV seronegative cases of pulmona...Objective:To determine the relationship of the capacity to produce interferon gamma(IFN-γ) in whole blood,bacteriological,hematological,radiographic and clinical presentations in new,HIV seronegative cases of pulmonary tuberculosis(TB).Methods:80 cases and 50 control subjects aged 15 years onwards,representative of Kasturba Hospital and Nursing schools of Wardha district of Maharashtra state in India were examined for their health condition with standard methodology.Results:Among these TB patients,73.8%were Quantiferon-TB gold (QFT) positive with IFN-γconcentration as 0.35 IU or more and there was none in healthy controls.The mean IFN-γconcentrations varied between 9.58 IU(50-59 yrs) and 2.58 IU(≥60 yrs),showing no trend.The differences in positivity and mean IFN-γconcentrations were statistically insignificant.Both the QFT positivity and IFN-γconcentrations were higher in normal lymphocyte percent as compared to below and above normal,but differences were not statistically significant.Conclusions:The IFN-γconcentrations are not correlated with any of the predictors of disease severity studied,the levels are significantly higher in observation group as compared to healthy group.展开更多
Background: Ustekinumab is a human monoclonal antibody that binds to the shared P40 subunit of interleukin (IL)-12 and IL-23 and is approved for the treatment of moderate-to-severe psoriasis. Latent tuberculosis (LTBI...Background: Ustekinumab is a human monoclonal antibody that binds to the shared P40 subunit of interleukin (IL)-12 and IL-23 and is approved for the treatment of moderate-to-severe psoriasis. Latent tuberculosis (LTBI) was diagnosed based on a positive tuberculin skin test (TST) or QuantiFERON-TB test without evidence of active tuberculosis (TB). Aim: To evaluate the risk of active tuberculosis reinfection in patients with a history of psoriasis and LTBI after INH prophylaxis treated with Ustekinumab. Case Report: We are describing 3 patients with a history of moderate-to-severe plaque psoriasis and newly identified LTBI who have been treated with INH monotherapy before starting Ustekinumab therapy followed-up over 2 years for any sign of tuberculosis reinfection. Conclusion: Ustekinumab is an option for treating psoriasis and LTBI with minimal risk of reactivation after INH prophylaxis.展开更多
文摘目的:评估QuantiFERON~-TB(QFT)、结核菌素皮肤试验(TST)及两种方法联合(TST+QFT)检测在法国接种过卡介苗(BCG)人群结核潜伏感染(LTBI)的成本效益。方法:建立决策分析模型评估结核(TB)密切接触成人三种检测方案的效果,并计算直接医疗成本,预期寿命和增量费用-效果比率(incremental cost-effectiveness ratios,ICERs)。结果:每位病人在无检测、TST检测、QFT检测和TST+QFT检测时兑现直接医疗费用分别为417欧元、476欧元、443欧元、435欧元,而兑现预期寿命分别为25.030、25.071、5.073和25.062年。相比QFT,TST的成本较高、效率低;与未检测相比,TST+QFT检测与获得每个生命年(year of life gained,YLG)需560欧元的一个ICER有关。与TST+QFT相比,QFT检测与获得每个生命年需730欧元的一个ICER有关。只有在LTBI率低(<5%)和TST特异性高(>90%)的情况下,QFT与ICER>75 000欧元/YLG有关。结论:在法国,各种诊断结核病密切接触者LTBI的方法中...
基金supported by a grant for a‘Study for effective TB controlincluding a cost-benefitanalysis of periodic health examination and BCG’from the Japanese Ministry of HealthLabour and Welfare(grant no17210601)
文摘Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.
文摘Introduction: The objective of this study was the comparison of the results of T-SPOT.TB using pleural effusion (PE) with those of IGRAs using peripheral blood (PB) or other diagnostic methods for the diagnosis of tuberculous (TB) pleurisy. Methods: We measured adenosine deaminase (ADA) in PE, QuantiFERON TB-Gold In-Tube (QFT), and T-SPOT.TB using PB, and T-SPOT.TB using PE. The definite group of TB pleurisy included 12 patients and other disease group 33 patients. Main find-ings: Sensitivity for QFT using PB was 83% and specificity was 85%, sensitivity for T-SPOT.TB using PB was 92% and specificity was 82%, while sensitivity for ADA in PE was 83% and specificity was 76%. When we adopted the same cut-off level of a positive response for T-SPOT.TB as PB using PE, sensitivity for T-SPOT.TB using PE was 100% and specificity was 82%, respectively. Although there were no significant differences among the four diagnostic methods, sensitivity for T-SPOT.TB using PE gave the most accurate diagnosis of TB-definite patients compared to ADA in PE or QFT using PB. Conclusions: If we performed T-SPOT.TB using a local specimen from the infection site, we could obtain a higher sensitivity than IGRAs using PB or ADA in PE and the numbers of ESAT-6 and CFP-10-positive SFCs were 3 to 5 fold higher in PEMCs than in PBMCs. T-SPOT.TB using PE may become a useful diagnostic method for TB pleurisy.
文摘Objective:To determine the relationship of the capacity to produce interferon gamma(IFN-γ) in whole blood,bacteriological,hematological,radiographic and clinical presentations in new,HIV seronegative cases of pulmonary tuberculosis(TB).Methods:80 cases and 50 control subjects aged 15 years onwards,representative of Kasturba Hospital and Nursing schools of Wardha district of Maharashtra state in India were examined for their health condition with standard methodology.Results:Among these TB patients,73.8%were Quantiferon-TB gold (QFT) positive with IFN-γconcentration as 0.35 IU or more and there was none in healthy controls.The mean IFN-γconcentrations varied between 9.58 IU(50-59 yrs) and 2.58 IU(≥60 yrs),showing no trend.The differences in positivity and mean IFN-γconcentrations were statistically insignificant.Both the QFT positivity and IFN-γconcentrations were higher in normal lymphocyte percent as compared to below and above normal,but differences were not statistically significant.Conclusions:The IFN-γconcentrations are not correlated with any of the predictors of disease severity studied,the levels are significantly higher in observation group as compared to healthy group.
文摘Background: Ustekinumab is a human monoclonal antibody that binds to the shared P40 subunit of interleukin (IL)-12 and IL-23 and is approved for the treatment of moderate-to-severe psoriasis. Latent tuberculosis (LTBI) was diagnosed based on a positive tuberculin skin test (TST) or QuantiFERON-TB test without evidence of active tuberculosis (TB). Aim: To evaluate the risk of active tuberculosis reinfection in patients with a history of psoriasis and LTBI after INH prophylaxis treated with Ustekinumab. Case Report: We are describing 3 patients with a history of moderate-to-severe plaque psoriasis and newly identified LTBI who have been treated with INH monotherapy before starting Ustekinumab therapy followed-up over 2 years for any sign of tuberculosis reinfection. Conclusion: Ustekinumab is an option for treating psoriasis and LTBI with minimal risk of reactivation after INH prophylaxis.
