Logo do repositório

Percorrer por autor "Sester, Martina"

A mostrar 1 - 2 de 2
  • Diagnostic accuracy and predictive value of the QuantiFERON-TB gold plus assay for tuberculosis in immunocompromised individuals: a prospective TBnet study
    Publication . Sester, Martina; Altet-Gomez, Neus; Andersen, Åse Bengaard; Arias-Guillén, Miguel; Avsar, Korkut; Bakken Kran, Anne-Marte; Bothamley, Graham; Nordholm Breschel, Anne Christine; Brown, James; Chesov, Dumitru; Ciobanu, Nelly; Cirillo, Daniela Maria; Crudu, Valeriu; de Souza Galvao, Malu; Dilektasli, Asli Görek; Dominguez, José; Duarte, Raquel; Dyrhol-Riise, Anne Ma; Goletti, Delia; Hoffmann, Harald; Ibraim, Elmira; Kalsdorf, Barbara; Krawczyk, Marcin; Kunst, Heinke; Lange, Berit; Lipman, Marc; Matteelli, Alberto; Milkiewicz, Piotr; Neyer, David; Nitschke, Martin; Oral, Haluk Barbaros; Palacios-Gutiérrez, Juan José; Petruccioli, Elisa; Raszeja-Wyszomirska, Joanna; Ravn, Pernille; Rupp, Jan; Spohn, Hanna-Elisa; Toader, Corina; Villar-Hernandez, Raquel; Wagner, Dirk; van Leth, Frank; Martinez, Leonardo; Pedersen, Ole Skouvig; Lange, Christoph
    Background: In low tuberculosis (TB)-endemic countries, tuberculosis preventive therapy (TPT) is recommended for immunocompromised individuals with a positive immunodiagnostic test. This study aimed to assess the performance of the QuantiFERON-TB Gold Plus (QFT+) assay and predictive power for future tuberculosis in immunocompromised individuals. Methods: In this prospective observational study, immunocompromised adults ≥18 years of age including people living with HIV (PLHIV), chronic renal failure, rheumatoid arthritis, solid-organ transplantation or stem-cell transplantation, and immunocompetent adults with and without TB-disease were recruited at 21 sites in 11 European countries and tested with the QFT+ assay. Individuals without TB-disease were followed up for the development of tuberculosis. TB incidence rates (IR) were calculated, stratified by QFT+ results and acceptance of TPT. This study is registered with Clinicaltrials.gov, NCT02639936. Findings: A total of 2663 individuals (1115 female, 1548 male) were enrolled from 03/11/2015 to 29/03/2019. Persons without tuberculosis were followed up for at least two years. Among 1758 immunocompromised individuals without active tuberculosis, 13.6% had positive QFT+ results. Sensitivity and specificity for TB-disease were 70.0% (52.1-83.3%) and 91.4% (89.6-92.9%), respectively, in immunocompromised, and 81.4% (76.6-85.3%) and 96.0% (92.5-97.9%), respectively, in immunocompetent individuals. During 2457 cumulative years of follow-up among 932 individuals with chronic renal failure, rheumatoid arthritis, solid-organ transplantation or stem-cell transplantation, including 83 persons with a positive QFT+ test without TPT, no-one developed active tuberculosis. In contrast, among 642 PLHIV without TPT, one with an indeterminate QFT+ and 3/30 individuals with a positive QFT+ developed active tuberculosis; all had detectable HIV-replication and low CD4 T-cell counts (incidence 4.1 (95% CI (1.3-12.4) per 100 person-years). No individuals receiving TPT developed active tuberculosis during 269 years of follow-up. Interpretation: In immunocompromised individuals in low TB-endemic countries, the 2-year-risk for active tuberculosis was highest among PLHIV with detectable HIV-replication and low CD4-counts. In this study, the QFT+ assay did not strongly predict progression to active tuberculosis, which emphasises the need to incorporate additional risk factors.
    2025-08-06Artigo científico Acesso aberto Ver mais
  • Tuberculosis incidence in solid organ transplant recipients in Europe: A multicenter TBnet cohort study
    Publication . Lange, Berit; Brehm, Thomas Theo; Arend, Sandra M.; Arias-Guillén, Miguel; Bakker, Marleen; Berastegui, Cristina; Babiker, Maaz; Charif, Rawya; Duarte, Raquel; Flick, Holger; Hofland, Regina W.; Ismail, Joanna; Kniepeiss, Daniela; Krepel, Jessica; Krishnan, Nithya; Kuijpers, Dora L.; Kunst, Heinke; van Leth, Frank; Lezaic, Visnja; Los-Arcos, Ibai; Machová, Jana; Milburn, Heather; Morais, Sandra A.; Kon, Onn Min; Osoro-Suarez, Carmen; Pessegueiro Miranda, Helena; Pesut, Dragica; Rahman, Ananna; Reischig, Tomas; Sánchez-Montalvá, Adrián; Spohn, Hanna Elisa; Stegenga, Merel T.; de Vries, Aiko P. J.; Wagner, Dirk; Wobser, Rika; Lange, Christoph; Sester, Martina
    Background: Solid organ transplant (SOT) recipients face elevated tuberculosis risk, yet optimal prevention strategies in low- to medium-incidence regions remain unclear. Methods: We conducted a multicenter retrospective cohort study of adult SOT recipients transplanted between 2007 and 2012 at 15 European centers, with follow-up through 2018. The primary outcome was microbiologically confirmed post-transplant tuberculosis. Incidence rates were calculated per 100,000 person-years; standardized incidence ratios (SIRs) used World Health Organization country-specific background rates. Cox models assessed risk factors. Results: Among 5805 patients (median age 51; 62.7% male; 73.9% renal transplants), 33.8% were tested for tuberculosis infection and 10.3% received tuberculosis preventive therapy (TPT). Over 33,785 person-years, 23 patients (0.4%) developed tuberculosis (68.0/100,000 person-years). Highest incidence occurred in patients with positive screening but no TPT (233.8/100,000). Incidence was higher in Southern vs. Central Europe (251.9 vs. 28.7/100,000), with pooled SIRs of 12.8 and 3.1, respectively. Tuberculosis risk was elevated among Southern European recipients (HR 22.9) and those with migration history (HR 2.7). Conclusion: Tuberculosis risk is increased in European SOT recipients. Regionally adapted prevention strategies, including targeted screening in low-incidence areas and universal screening in higher-incidence regions, are warranted.
    2025-12-20Artigo científico Acesso aberto Ver mais