Latent tuberculosis treatment results in patients that taken Tnf-alpha blockers at Ankara Numune Training and Research Hospital Chest Diseases Clinic for last 8 years (2006-2013)

Abstract

INTRODUCTION: Tuberculosis occurrence was evaluated in patients that applied tuberculosis chemoprophylaxis and currently receiving tumor necrosis factor-alpha (TNF-alpha) blocker. MATERIALS AND METHODS: Incidence of tuberculosis were retrospectively evaluated in patients that currently receiving TNF-alpha-blocking therapy and received tuberculosis chemoprophylaxis at Ankara Numune Education and Research Hospital, Lung Disease Department, between 2006-2013 years. 134 patients that were diagnosed with rheumatologic and dermatologic diseases, were evaluated. Patients were in the age range 18-80 years. Age, gender, smoking status, BCG vaccination, chest radiography, diagnose of disease, presence of concomitant disease, tuberculosis story, PPD value, chemoprophylaxis acquisition, which anti-tuberculosis agents received, duration of chemoprophylaxis, duration of TNF-alpha blocker, other immunosuppressive using were measured. RESULTS: Rheumatologic diseases were often. Prophylaxis has given at 73.9% of patients. Patients with received anti-TNF-alpha therapy (n= 134) have not developed pulmonary or extra-pulmonary tuberculosis disease. CONCLUSION: Patients with received anti-TNF-alpha therapy, are scanned with TST or Quantiferon. If latent tuberculosis infection are diagnosed, tuberculosis prophylaxis should be started pre-anti-TNF-alpha therapy at least one month and INH chemoprophylaxis should be completed on 9 months or RIF should be completed on 4 months. Serum liver enzymes and bilirubin measurements monthly; follow-up physical examination and chest radiography should be performed for 3 months.