ABSTRACT
Background: The risk of Tuberculosis reactivation in Hemodialysis [HD] patients is increased. Tuberculin skin test [TST] is not usually helpful in detecting tuberculosis [TB] infection because of the anergic reaction and the inability to differentiate latent from eradicated TB infection. In this study we evaluated TST and serum Lipoarabinomannan [anti-LAM] antibody detection for the diagnosis of TB in a dialysis population. In addition, the percentage of positivity to purified protein derivatives [PPD] immunoglobulins IgG and IgM in serum was also evaluated
Methods: A total of 80 HD patients were screened using TST [Mantoux method], anti-LAM test [MycoDot Mossman diagnostic] and immunoglobulin IgG and IgM to PPD. In addition 40 healthy volunteers never treated for TB were included as controls. Test Results were compared with clinical and radiological findings
Results: A total of 80 patients and 40 controls were evaluated by TST, MycoDot and PPD ELISA tests. They were 56 [70%] males and 24 [30%] females TST was positive in 20 [25%] of the patients and in 12 [30%] of the controls. Anti-LAM was positive in 32 [40%] of the patients and in 4 [10%] of the controls. Significant correlation was found between TST and both anti-LAM and IgM PPD ELISA tests in the patients group while highly significant difference was found between the patients and controls groups as regards anti-LAM antibody test. A significant correlation was found between anti-LAM test and the pulmonary symptoms, while no significant relationship was found between the test and the other clinical or radiological findings
Conclusion: Serodiagnostic testing may be useful in detecting TB infection in HD patients. MycoDot test is relatively simple and inexpensive and combination of serological tests may increase the effectiveness of serodiagnosis. More researches on a larger scale are needed in addition to a longitudinal study to assess the association of positive tests and the subsequent risk of TB reactivation in those patients