Human T-cell leukemia virus type 1 may invalidate T-SPOT.TB assay results in rheumatoid arthritis patients: A retrospective case-control observational study

Kunihiko Umekita, Yayoi Hashiba, Kosho Iwao, Chihiro Iwao, Masatoshi Kimura, Yumi Kariya, Kazuyoshi Kubo, Shunichi Miyauchi, Risa Kudou, Yuki Rikitake, Katoko Takajo, Takeshi Kawaguchi, Motohiro Matsuda, Ichiro Takajo, Eisuke Inoue, Toshihiko Hidaka and Akihiko Okayama

PLOS ONE, 2020, vol. 15, issue 5, 1-13

Abstract: Background: CD4-positive T cells are the main target of human T-cell leukemia virus type 1 (HTLV-1). Interferon-γ release assays rely on the fact that T-lymphocytes release this cytokine when exposed to tuberculosis-specific antigens and are useful in testing for latent tuberculosis infection before initiating biologic therapy, such as anti-tumor necrosis factor agents. However, the reliability of interferon-γ release assays in detecting tuberculosis infection among HTLV-1-positive patients with rheumatoid arthritis (RA) remains unclear. The present study aimed to evaluate the use of the T-SPOT.TB assay in HTLV-1-positive RA patients. Methods: Overall, 29 HTLV-1-positive RA patients and 87 age- and sex-matched HTLV-1-negative RA patients (controls) were included from the HTLV-1 RA Miyazaki Cohort Study. Results of the T-SPOT.TB assay for latent tuberculosis infection screening were collected from medical records of patients. Results: Approximately 55% of the HTLV-1-positive RA patients showed invalid T-SPOT.TB assay results (odds ratio: 108, 95% confidence interval: 13.1–890, p 10 in the negative controls. HTLV-1 proviral load values were significantly higher in patients with invalid results compared with those without invalid results (p = 0.003). Conclusion: HTLV-1 infection affects T-SPOT.TB assay results in RA patients. Assay results in HTLV-1 endemic regions should be interpreted with caution when screening for latent tuberculosis infection before initiation of biologic therapy.

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0233159

DOI: 10.1371/journal.pone.0233159

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