Risk of progression to active tuberculosis for indeterminate interferon-gamma release assay in immunocompromised individuals: a systematic review and meta-analysis
机构：[1]Department of Science and Research, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, YunnanProvince, China[2]Department of Immunology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union MedicalCollege, Beijing, China[3]Department of Pulmonary and Critical Care Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology,Kunming, Yunnan Province, China内科片外科片呼吸与危重症医学科重症医学科[4]Department of Endocrinology, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China内科片内分泌科[5]School of Basic Medical Sciences, Kunming Medical University, Kunming, Yunnan Province, China[6]Department of Medical Imaging, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, YunnanProvince, China
Background: Limited data exist on assessing the risk of active tuberculosis (TB) in immunocompromised individuals during screening for latent tuberculosis infection (LTBI).Objectives: To assess the risk of progression to active TB for indeterminate interferon-g release assays (IGRA) results in immunocompromised individuals during screening for LTBI. Data sources: PubMed, Embase, Web of Science, and the Cochrane Library were searched without start date or language restrictions on 18 April 2023.Study eligibility criteria: Cohort study or randomized controlled trials that investigated the risk of progression to active TB for indeterminate IGRA during LTBI screening.Participants: Immunocompromised individuals. Test: IGRA (T-SPOT.TB and QuantiFERON).Reference standard: None.Assessment of risk of bias: A modified version of the Newcastle-Ottawa Scale.Methods of data synthesis: Fixed effects meta-analysis was used to obtain two pooled risk ratios (RRs). RR-ip represented disease progression rate in untreated individuals with indeterminate IGRA versus positive IGRA. RR-in represented disease progression rate in untreated individuals with indeterminate IGRA versus negative IGRA.Results: Among the 5102 identified studies, 28 (14 792 immunocompromised individuals) were included. The pooled RR-ip and RR-in for cumulative incidence were 0.51 (95% CI, 0.32-0.82; I2 = 0%) and 2.94 (95% CI, 1.78-4.85; I2 = 0%), respectively. In addition, 11 studies reporting person-year data were included to verify the reliability of cumulative incidence results. The pooled RR-ip and RR-in for person-year incidence were 0.40 (95% CI, 0.19-0.82; I2 = 13%) and 2.67 (95% CI, 1.24-5.79; I2 = 23%), respectively.Discussion: Indeterminate IGRA results in immunocompromised individuals may represent an intermediate risk of progression to active TB, with half the risk for positive results and three times for negative results. Proper follow-up and management of patients with indeterminate results are crucial for mitigating progression risk and improving patient outcomes. Guozhong Zhou, Clin Microbiol Infect 2023;29:1375 (c) 2023 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
基金：
Talent Project of Kunming Health Science and Technology [2022-SW [Leading Talents] -001]; Special Project 'Spring City Plan' Famous Doctor [C202012016]
第一作者机构：[1]Department of Science and Research, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, YunnanProvince, China
通讯作者：
通讯机构：[6]Department of Medical Imaging, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, YunnanProvince, China[*1]Department of Radiology, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming,Yunnan Province, No. 2 Ganghe South Road, Anning City, Kunming City, Yunnan Province, 650302, China.
推荐引用方式(GB/T 7714)：
Zhou Guozhong,Luo Shiqi,He Jian,et al.Risk of progression to active tuberculosis for indeterminate interferon-gamma release assay in immunocompromised individuals: a systematic review and meta-analysis[J].CLINICAL MICROBIOLOGY AND INFECTION.2023,29(11):1375-1384.doi:10.1016/j.cmi.2023.07.003.
APA：
Zhou, Guozhong,Luo, Shiqi,He, Jian,Chen, Nan,Zhang, Yu...&Song, Chao.(2023).Risk of progression to active tuberculosis for indeterminate interferon-gamma release assay in immunocompromised individuals: a systematic review and meta-analysis.CLINICAL MICROBIOLOGY AND INFECTION,29,(11)
MLA：
Zhou, Guozhong,et al."Risk of progression to active tuberculosis for indeterminate interferon-gamma release assay in immunocompromised individuals: a systematic review and meta-analysis".CLINICAL MICROBIOLOGY AND INFECTION 29..11(2023):1375-1384
医学