To Predict the Potential of Development of Active Tuberculosis in Those Receiving Long-term Dialysis by Using Interferon-gamma Release Assy Clinical Trial
Official title:
Surveillance and Follow-up for Latent Tuberculosis Infection and Risk of Developing Active Tuberculosis in Patients Receiving Long-term Dialysis
To follow-up the latent tuberculosis infection and the risk of developing active tuberculosis in patients receiving long-term dialysis
Tuberculosis (TB) remains an important infectious disease worldwide. Taiwan is still an
edemic area. In 2008, there is an incidence of 62 persons having TB per 100,000 population.
To control TB, we should prevent further TB transmission via early diagnosis and treatment
of latent TB. In screening the risk population for TB, patients with renal failure acquiring
long-term dialysis, in addition to close contacts, have higher incidence and mortality than
general population. Moreover, the risk for active TB in dialysis patients is ten to 25 times
larger. In Taiwan, the dialysis group is important because it has higher prevalence (2228
per in per million people by 2009 annual report of United States Renal Data System) than
other countries in the world. In particular, the dialysis patients usually has an
extrapulmonary presentation for their TB, so diagnosis is always delay. Hence, we should
detect latent TB in those dialysis patients for monitor them from active tuberculosis.
Currently, interferon-gamma release assays (IGRAs) are used for finding out those with
latent TB and have been proven useful for those being immunocompromised, and having BCG
vaccination. For dialysis patients, IGRAs have been tested and been considered better than
skin tuberculin test. However, previous studied rarely observed the patients receiving
peritoneal dialysis. Besides, those cross-sectional studies used the indirect evidence for
diagnosis and lacked longitudinal follow-up. We thus conducted this study for observing the
prevalence of latent TB in those receiving hemodialysis or peritoneal dialysis by using
IGRAs. We also kept one-year follow-up for the primary outcome of active TB occurrence.
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Observational Model: Cohort, Time Perspective: Prospective