Research article

PREVALENCE OF LATENT TUBERCULOSIS INFECTION IN PATIENT WITH END-STAGE KIDNEY DISEASE UNDERGOING REGULAR HEMODIALYSIS

Huda Khalaf Jawad 1*, Muntadher Ali Alsaidi 2

Online First: April 14, 2023


Background and aim: Tuberculosis, caused by Mycobacterium tuberculosis, causes a condition known as the latent tuberculosis infection (LTBI) that often defined as asymptomatic condition in which tuberculosis organisms present in the lung tissue without any clinical or radiological signs. LTBI can become active TB in hosts who experience immunosuppression caused by comorbid disease or medical therapy. Since immune system alteration occurs, patients with chronic kidney disease (CKD) on routine hemodialysis (HD) have a greater risk for latent tuberculosis infection. Because infection in CKD patients increases the mortality, patients with end-stage renal disease (ESRD) undergoing hemodialysis are at risk of developing active TB 6 to 25 times higher than the general population. The importance of screening LTBI using diagnostic tests such as the QuantiFeron TB-Gold (QFT-G) and proper treatment or regular follow up in hemodialysis patients can prevent development active TB from reactivation of LTBI. Methods: This study conducted as cross sectional study and done in Wasit province. The blood specimens collected from human individuals with chronic kidney disease on regular hem dialysis, the subjects were recruited from September–December 2022. Subjects aged > 18 years at least have undergoing HD in 3 months and twice a week HD were included in this study. Tuberculosis (TB), contact status with TB patients, and history of previous TB was excluded. LTBI was diagnosed using interferon-γ release assays (IGRA). All data including age, gender, residence, smoking status, duration of HD, medical history of diabetes mellitus were obtained and recorded in case report form. Results: A total of 91 patients were involved LTBI based on positive result of IGRA was occurred in 28.6% subjects, while 61.5% and 9.9% subjects had negative and indeterminate IGRA, respectively. There is no significant correlation between age, gender, residence, and smoking status of patients with positivity of test. There is no significant correlation of duration of hemodialysis, diabetes as risk factors with positivity of test. Conclusion: the prevalence of LTBI in ESKD patients undergoing regular hemodialysis was high using IGRA in Wasit province.

Keywords

Mycobacterium tuberculosis, TB, Chronic kidney disease, QuantiFeron TB-Gold, Iraq