Abstract Background There is growing evidence that patients with chronic kidney disease (CKD) show a high risk of acquiring latent tuberculosis infection (LTBI) or of developing active TB. However, diagnosing LTBI is still a challenge based on current tests which reflect the cellular immunity against Mycobacterium tuberculosis infection – that may be compromised in this population. Herein, we evaluated the prevalence of LTBI among patients with CKD and those in routine hemodialysis, and LTBI predictors. Methods A prospective cross-sectional study was conducted in a tertiary nephrology reference hospital, Rio de Janeiro, Brazil. LTBI was diagnosed using interferon-gamma release assay (IGRA; QuantiFERON-TB Gold Plus [QFT-Plus]). CXCL-10/IP-10 release assay was determined from QFT-Plus supernatants. Results A total of 123 patients were enrolled in the study, 111 (90.2%) from the CKD group and 12 (9.8%) from the hemodialysis (HD). IGRA showed 39 (31.7%) positive results in the general study population: 36/111 (32.4%) in CKD and 3/12 (25%) in HD groups. Indeterminate IGRA results were observed in 4/123 (3.3%) patients. CXCL-10/IP-10 positive results were seen in 39/123 (39.8%) patients. Multivariate regression analysis identified that non-vaccination with BCG (aOR 7.41 [CI 2.15–25.48]; p = 0.0014) and the positivity for CXCL-10/IP-10 assay (aOR 4.48 [CI 1.87–10.76]; p = < 0.001) were independent risk factors for LTBI among DRC and HD patients. Conclusion The IGRA QFT-Plus was shown to be a useful method in the surveillance of LTBI in critical stages of CKD and routine hemodialysis. Mtb-specific CXCL-10/IP-10 responses were associated with a positive IGRA and could provide an useful adjuvant LTBI biomarker in this population.
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Silva et al. (2024) studied this question.
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