The T-SPOT.TB Assay used for Screening and Monitoring of Latent Tuberculosis Infection in Patients with Behçet's Disease pre- and post-anti-TNF treatment: A retrospective study.

BACKGROUND: Patients undergoing anti-tumor necrosis factor (TNF) treatment are more susceptible to latent tuberculosis infection (LTBI). The aim of the present study was to determine the rate of active TB in patients with Behçet's Disease (BD) pre- and post-anti-TNF treatment and to evaluate the long-term efficacy of LTBI screening as primary prophylaxis in China.

METHODS: This retrospective study included BD patients eligible for anti-TNF therapy at a single institution in Fudan University, China. Based on the results of T-SPOT.TB assay, chest radiography and history of exposure to TB, patients were screened and regularly followed up at 3-month intervals.

RESULTS: Eighty-nine BD patients with mean disease duration of 87.5 ± 86.1 months were included. Their median duration of anti-TNF therapy was 10.6 months. 51 patients were treated with Infliximab, 38 with Etanercept, and 4 with Adalimumab. While 84 patients received a consecutive single anti-TNF drug therapy, 5 patients switched to a second drug. 12 patients demonstrated positive results in LTBI screening: 3 had history of TB exposure and 9 were solely T-SPOT.TB-positive. Prior to anti-TNF treatment, LTBI treatment was initiated in 11 patients, and one patient refused treatment. With a median follow-up period of 27.9 months, we observed only one case (1.1%) of intestinal TB during Infliximab treatment.

CONCLUSION: Regardless of anti-TNF treatment, long-term screening via T-SPOT.TB assay might represent a more sensitive approach to identify BD patients with LTBI. As secondary prophylaxis, the LTBI treatment is effective in a country with high risk of TB.This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).