Prevalence of Positive QuantiFERON-TB Gold In-Tube Test in Uveitis and its Clinical Implications in a Country Nonendemic for Tuberculosis

• Published in: American journal of ophthalmology Vol. 211; pp. 151 - 158
• Main Authors: Groen-Hakan, Fahriye, van Laar, Jan A.M., Bakker, Marleen, van Hagen, P. Martin, Hardjosantoso, Hannah, Rothova, Aniki
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2020; Elsevier Limited
• Subjects: Adult; Aged; Antigens; Antitubercular Agents - therapeutic use; Biopsy; Calcification; Cross-Sectional Studies; False Positive Reactions; Female; Humans; Infections; Interferon-gamma Release Tests - methods; Localization; Male; Middle Aged; Mycobacterium tuberculosis - isolation & purification; Netherlands; Patients; Population; Prevalence; Retrospective Studies; Sarcoidosis; Tuberculin Test - methods; Tuberculosis; Tuberculosis, Ocular - diagnosis; Tuberculosis, Ocular - microbiology; Uveitis - diagnosis; Uveitis - microbiology; Netherlands
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2019.11.009

To report on the prevalence and clinical implications of positive QuantiFERON-Gold (QFT-G) test results in the diagnostic evaluation of a large cohort of consecutive patients with uveitis in the Netherlands. Retrospective cross-sectional study. This study included 710 consecutive patients who all underwent evaluation for uveitis including QFT-G testing. The ocular features, comorbidity, and abnormalities in diagnostic imaging and laboratory tests were registered for QFT-G–positive patients with uveitis. Of all patients, 13% (92/710) were positive for QFT-G. Previously treated tuberculosis (TB) was documented in 2 patients. Of all 92 QFT-G–positive patients, culture-proven active TB was observed in 1 case. The proportion of patients with uveitis of unknown etiology was higher in QFT-G–positive than in the QFT-G–negative patients (54/92, 59% vs 238/618, 39%; P = .0004). The uveitis features of QFT-G–positive patients were mainly nonspecific. Of all QFT-G–positive patients with uveitis, 17 patients had chest imaging changes suggesting either TB or sarcoidosis. Twenty-nine QFT-G–positive patients with otherwise unexplained uveitis completed antituberculous therapy (29/710; 4% of all included patients) with beneficial effect in most cases. The QFT-G tested positive in 13% of patients with uveitis in the Netherlands, whereas only sporadic patients had a documented previous or active TB infection. The proportion of patients with unexplained uveitis was higher in QFT-G–positive patients. Though the association between uveitis and a positive QFT-G test might be coincidental, the majority of treated QFT-G–positive patients with otherwise unexplained severe uveitis cause had a beneficial response to antituberculous therapy.