Safety and outcome of treatment of latent tuberculosis infection in liver transplant recipients
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany..
PURPOSE: Liver transplant (LT) recipients have an increased risk of tuberculosis (TB), which is associated with higher mortality rates. This retrospective cohort study assessed the outcome and tolerability of screening and treatment of latent tuberculosis infection (LTBI) in LT recipients.
METHODS: Between March 2020 and February 2022, all adult LT candidates at our institution were screened for LTBI. The candidates who tested positive for interferon-γ-releasing assay or met epidemiological or clinical-radiological criteria for LTBI were treated and monitored.
RESULTS: Among the 857 LT recipients, 199 (23.2%) were diagnosed with LTBI, of which 171 (85.9%) initiated LTBI treatment. The median duration of follow-up was 677 days. Adequate LTBI treatment occurred in 141/171 (82.5%) patients and was discontinued prematurely in 30/171 (17.5%) patients. The most common reason for discontinuation was liver enzyme elevation (11/30, 36.7%), although only five discontinued treatment due to suspicion of isoniazid-associated hepatotoxicity. None of the LTBI-treated patients developed active TB during the follow-up period, while 3.6% (1/28) of untreated LTBI patients and 0.6% (4/658) of patients without LTBI developed TB.
CONCLUSION: These findings demonstrate that LTBI screening and treatment is a safe and effective strategy to prevent TB in LT recipients. However, monitoring for adverse events and liver enzyme elevation is recommended.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Infection - (2024) vom: 13. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lee, Yun Woo [VerfasserIn] |
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| Links: |
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| Themen: |
Interferon-γ-releasing assay |
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| Anmerkungen: |
Date Revised 12.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s15010-023-02161-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368375005 |
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| 245 | 1 | 0 | |a Safety and outcome of treatment of latent tuberculosis infection in liver transplant recipients |
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| 500 | |a Date Revised 12.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany. | ||
| 520 | |a PURPOSE: Liver transplant (LT) recipients have an increased risk of tuberculosis (TB), which is associated with higher mortality rates. This retrospective cohort study assessed the outcome and tolerability of screening and treatment of latent tuberculosis infection (LTBI) in LT recipients | ||
| 520 | |a METHODS: Between March 2020 and February 2022, all adult LT candidates at our institution were screened for LTBI. The candidates who tested positive for interferon-γ-releasing assay or met epidemiological or clinical-radiological criteria for LTBI were treated and monitored | ||
| 520 | |a RESULTS: Among the 857 LT recipients, 199 (23.2%) were diagnosed with LTBI, of which 171 (85.9%) initiated LTBI treatment. The median duration of follow-up was 677 days. Adequate LTBI treatment occurred in 141/171 (82.5%) patients and was discontinued prematurely in 30/171 (17.5%) patients. The most common reason for discontinuation was liver enzyme elevation (11/30, 36.7%), although only five discontinued treatment due to suspicion of isoniazid-associated hepatotoxicity. None of the LTBI-treated patients developed active TB during the follow-up period, while 3.6% (1/28) of untreated LTBI patients and 0.6% (4/658) of patients without LTBI developed TB | ||
| 520 | |a CONCLUSION: These findings demonstrate that LTBI screening and treatment is a safe and effective strategy to prevent TB in LT recipients. However, monitoring for adverse events and liver enzyme elevation is recommended | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Interferon-γ-releasing assay | |
| 650 | 4 | |a Isoniazid | |
| 650 | 4 | |a Latent tuberculosis infection | |
| 650 | 4 | |a Liver transplantation | |
| 650 | 4 | |a Tuberculosis | |
| 700 | 1 | |a Chung, Hyemin |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Sung-Han |e verfasserin |4 aut | |
| 700 | 1 | |a Sung, Heungsup |e verfasserin |4 aut | |
| 700 | 1 | |a Ha, Su-Min |e verfasserin |4 aut | |
| 700 | 1 | |a Jwa, Eun-Kyoung |e verfasserin |4 aut | |
| 700 | 1 | |a Jung, Dong-Hwan |e verfasserin |4 aut | |
| 700 | 1 | |a Moon, Deok-Bog |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Sung-Gyu |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Sang-Oh |e verfasserin |4 aut | |
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