Mycobacterium tuberculosis: Active disease and latent infection in a renal transplant cohort

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background
Tuberculosis (TB) is a serious opportunistic infection in renal transplant recipients associated with high mortality. Screening and treatment of latent Mycobacterium tuberculosis infection (LTBI) offers an opportunity to prevent subsequent active disease.

Methods
We retrospectively reviewed the records of all adult patients who underwent renal transplantation at our centre from 2005 to 2014 to assess current screening practices, the risks for and burden of active TB.

Results
A total of 660 individuals underwent renal transplantation during this period, totalling 3647 person years of follow up. Three patients were diagnosed with active TB after renal transplant, resulting in an incidence of 82 per 100,000 person‐years. Of 656 transplant recipients, 102 (15.5%) were born in high TB incidence countries and 89 (13.5%) had an interferon gamma release assay (IGRA) at any point. Individuals born in high TB risk countries had a much higher incidence of active TB (530 per 100,000 person‐years). Ten individuals had positive IGRA tests, of whom two were treated for active TB, two received chemoprophylaxis and six were not treated.

Conclusions
In the absence of formal guidelines, IGRA‐based screening for LTBI was infrequently performed. Our data suggests that screening and treatment of renal transplant recipients born in high incidence countries is an important preventive measure.
Original languageEnglish
Number of pages18
JournalNephrology
DOIs
Publication statusAccepted/In press - 16 Apr 2018

Cite this

@article{ef115dc287714f8e81cfc86abfc69d1c,
title = "Mycobacterium tuberculosis: Active disease and latent infection in a renal transplant cohort",
abstract = "BackgroundTuberculosis (TB) is a serious opportunistic infection in renal transplant recipients associated with high mortality. Screening and treatment of latent Mycobacterium tuberculosis infection (LTBI) offers an opportunity to prevent subsequent active disease.MethodsWe retrospectively reviewed the records of all adult patients who underwent renal transplantation at our centre from 2005 to 2014 to assess current screening practices, the risks for and burden of active TB.ResultsA total of 660 individuals underwent renal transplantation during this period, totalling 3647 person years of follow up. Three patients were diagnosed with active TB after renal transplant, resulting in an incidence of 82 per 100,000 person‐years. Of 656 transplant recipients, 102 (15.5{\%}) were born in high TB incidence countries and 89 (13.5{\%}) had an interferon gamma release assay (IGRA) at any point. Individuals born in high TB risk countries had a much higher incidence of active TB (530 per 100,000 person‐years). Ten individuals had positive IGRA tests, of whom two were treated for active TB, two received chemoprophylaxis and six were not treated.ConclusionsIn the absence of formal guidelines, IGRA‐based screening for LTBI was infrequently performed. Our data suggests that screening and treatment of renal transplant recipients born in high incidence countries is an important preventive measure.",
author = "Nastaran Rafiei and Jackie Williams and Mulley, {William R.} and Trauer, {James M.} and Jenkin, {Grant A.} and Rogers, {Benjamin A.}",
year = "2018",
month = "4",
day = "16",
doi = "10.1111/nep.13386",
language = "English",
journal = "Nephrology",
issn = "1320-5358",
publisher = "Wiley-Blackwell",

}

Mycobacterium tuberculosis : Active disease and latent infection in a renal transplant cohort. / Rafiei, Nastaran; Williams, Jackie; Mulley, William R.; Trauer, James M.; Jenkin, Grant A.; Rogers, Benjamin A.

In: Nephrology, 16.04.2018.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Mycobacterium tuberculosis

T2 - Active disease and latent infection in a renal transplant cohort

AU - Rafiei, Nastaran

AU - Williams, Jackie

AU - Mulley, William R.

AU - Trauer, James M.

AU - Jenkin, Grant A.

AU - Rogers, Benjamin A.

PY - 2018/4/16

Y1 - 2018/4/16

N2 - BackgroundTuberculosis (TB) is a serious opportunistic infection in renal transplant recipients associated with high mortality. Screening and treatment of latent Mycobacterium tuberculosis infection (LTBI) offers an opportunity to prevent subsequent active disease.MethodsWe retrospectively reviewed the records of all adult patients who underwent renal transplantation at our centre from 2005 to 2014 to assess current screening practices, the risks for and burden of active TB.ResultsA total of 660 individuals underwent renal transplantation during this period, totalling 3647 person years of follow up. Three patients were diagnosed with active TB after renal transplant, resulting in an incidence of 82 per 100,000 person‐years. Of 656 transplant recipients, 102 (15.5%) were born in high TB incidence countries and 89 (13.5%) had an interferon gamma release assay (IGRA) at any point. Individuals born in high TB risk countries had a much higher incidence of active TB (530 per 100,000 person‐years). Ten individuals had positive IGRA tests, of whom two were treated for active TB, two received chemoprophylaxis and six were not treated.ConclusionsIn the absence of formal guidelines, IGRA‐based screening for LTBI was infrequently performed. Our data suggests that screening and treatment of renal transplant recipients born in high incidence countries is an important preventive measure.

AB - BackgroundTuberculosis (TB) is a serious opportunistic infection in renal transplant recipients associated with high mortality. Screening and treatment of latent Mycobacterium tuberculosis infection (LTBI) offers an opportunity to prevent subsequent active disease.MethodsWe retrospectively reviewed the records of all adult patients who underwent renal transplantation at our centre from 2005 to 2014 to assess current screening practices, the risks for and burden of active TB.ResultsA total of 660 individuals underwent renal transplantation during this period, totalling 3647 person years of follow up. Three patients were diagnosed with active TB after renal transplant, resulting in an incidence of 82 per 100,000 person‐years. Of 656 transplant recipients, 102 (15.5%) were born in high TB incidence countries and 89 (13.5%) had an interferon gamma release assay (IGRA) at any point. Individuals born in high TB risk countries had a much higher incidence of active TB (530 per 100,000 person‐years). Ten individuals had positive IGRA tests, of whom two were treated for active TB, two received chemoprophylaxis and six were not treated.ConclusionsIn the absence of formal guidelines, IGRA‐based screening for LTBI was infrequently performed. Our data suggests that screening and treatment of renal transplant recipients born in high incidence countries is an important preventive measure.

U2 - 10.1111/nep.13386

DO - 10.1111/nep.13386

M3 - Article

JO - Nephrology

JF - Nephrology

SN - 1320-5358

ER -