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Prevalence of latent tuberculosis infection and its risk factors in Japanese hemodialysis patients

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Abstract

Background

The majority of active tuberculosis (TB) cases develop from latent tuberculosis infection (LTBI). Since the risk of TB in hemodialysis (HD) patients is particularly high, interferon-gamma release assay (IGRA) for LTBI screening in HD patients is considered important. However, the prevalence and characteristics of LTBI in Japanese HD patients remain obscure.

Methods

We performed an observational cross-sectional study of LTBI using IGRA QFT-3G tests in 118 HD outpatients enrolled at 3 hospitals of varying location and function.

Results

Of the 118 patients, 96 were QFT negative, 7 were QFT indeterminate, 14 were QFT positive, and 1 was QFT judgment impossible. No patient had active TB. Confirmed (QFT positive) and possible (QFT positive + indeterminate) LTBI patients totaled 14 (11.9%) and 21 (17.8%), respectively. The LTBI possible group was significantly older and had a significantly higher rate of nephrosclerosis versus the QFT-negative group. The indeterminate group had a significantly longer HD period. The QFT results were not remarkably affected by other clinical data, including hospital characteristics. The possible LTBI rate increased age-dependently, with higher values from 60 years of age.

Conclusions

The prevalence of LTBI is high in Japanese HD patients, especially from the age of 60 years. Older age was a significant risk factor for LTBI, with prediction difficult using other clinical data. Extended HD may mask IGRA results. Therefore, aggressive screening for LTBI is advised in all HD patients regardless of hospital region or type, especially in patients over 60 years of age or newly commencing HD.

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Authors and Affiliations

  1. Department of Nephrology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan

    Yohei Ogawa, Makoto Harada, Koji Hashimoto & Yuji Kamijo

Authors
  1. Yohei Ogawa
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  2. Makoto Harada
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  3. Koji Hashimoto
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  4. Yuji Kamijo
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Corresponding author

Correspondence to Yuji Kamijo.

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The authors have declared that no conflict of interest exists.

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All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (Shinshu University Ethics Committee; IRB approval number 3320) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all individual participants included in the study.

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Ogawa, Y., Harada, M., Hashimoto, K. et al. Prevalence of latent tuberculosis infection and its risk factors in Japanese hemodialysis patients. Clin Exp Nephrol 25, 1255–1265 (2021). https://doi.org/10.1007/s10157-021-02093-w

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  • DOI: https://doi.org/10.1007/s10157-021-02093-w

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