Abstract
Purpose
Liver transplant (LT) recipients have an increased risk of tuberculosis (TB), which is associated with higher mortality rates. This retrospective cohort study assessed the outcome and tolerability of screening and treatment of latent tuberculosis infection (LTBI) in LT recipients.
Methods
Between March 2020 and February 2022, all adult LT candidates at our institution were screened for LTBI. The candidates who tested positive for interferon-γ-releasing assay or met epidemiological or clinical-radiological criteria for LTBI were treated and monitored.
Results
Among the 857 LT recipients, 199 (23.2%) were diagnosed with LTBI, of which 171 (85.9%) initiated LTBI treatment. The median duration of follow-up was 677 days. Adequate LTBI treatment occurred in 141/171 (82.5%) patients and was discontinued prematurely in 30/171 (17.5%) patients. The most common reason for discontinuation was liver enzyme elevation (11/30, 36.7%), although only five discontinued treatment due to suspicion of isoniazid-associated hepatotoxicity. None of the LTBI-treated patients developed active TB during the follow-up period, while 3.6% (1/28) of untreated LTBI patients and 0.6% (4/658) of patients without LTBI developed TB.
Conclusion
These findings demonstrate that LTBI screening and treatment is a safe and effective strategy to prevent TB in LT recipients. However, monitoring for adverse events and liver enzyme elevation is recommended.
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Data availability
The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
Abbreviations
- LT:
-
Liver transplant
- TB:
-
Tuberculosis
- LTBI:
-
Latent tuberculosis infection
- SOT:
-
Solid organ transplantation
- IGRA:
-
Interferon-γ-releasing assay
- ID:
-
Infectious disease
- IQR:
-
Interquartile range
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Conceptualization: S-OL; Data acquisition: HC, HS, S-MH, E-KJ, D-HJ, D-BM, Data analysis and interpretation: YWL, S-OL, S-HK, HS; Supervision: S-GL, S-HK, D-HJ, D-BM; Visualization: YWL, S-OL; Writing—Original draft: YWL; Writing—Review and editing: S-OL. All authors approved the manuscript.
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Lee, Y.W., Chung, H., Kim, SH. et al. Safety and outcome of treatment of latent tuberculosis infection in liver transplant recipients. Infection (2024). https://doi.org/10.1007/s15010-023-02161-1
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DOI: https://doi.org/10.1007/s15010-023-02161-1