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We assessed the prevalence of positive screening tests for LTBI, hepatitis B virus (HBV), and hepatitis C virus (HCV) in patients screened at a large rheumatology outpatient center in Germany.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Method<\/jats:title>\n            <jats:p>This retrospective cohort study used electronic health records from adult rheumatology patients. The presence of LTBI was evaluated by chest X-rays, patient medical history\/self-report, and QuantiFERON\u00ae-TB Gold Plus (QFT) interferon-gamma release assays. Antibodies to HBV core antigen (anti-HBc) and HCV were used to assess HBV and HCV, respectively. Statistically significant associations were evaluated by Fisher exact tests.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 697 screened patients with a rheumatological condition (61.3% female, mean age 60.0\u00a0years), 132 (18.9%) patients were positive for LTBI (99 [14.2%]), anti-HBc (39 [5.6%]), or anti-HCV (3 [0.4%]). Nine patients had more than one positive result; different infections were not significantly associated. QFT detected the most LTBI cases (59.5%) followed by patient report\/history (42.4%) and chest X-rays (17.2%). Although most patients (83.8%) were positive on only one test, associations among LTBI tests were statistically significant. Biologic disease-modifying antirheumatic drug (bDMARD) use was lower in patients with a positive LTBI screening result compared with all screened patients (73.7% vs 86.4%) and targeted synthetic DMARD (tsDMARD) use was higher (10.1% vs 5.9%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Almost one-fifth of rheumatology patients preparing to initiate intensified immunosuppressive therapy have positive results on screening tests for LTBI or show evidence of exposure to HBV or HCV. These findings support the need for careful screening, even in \u201clow-prevalence\u201d countries.<\/jats:p>\n            <jats:table-wrap>\n              <jats:table>\n                <jats:tbody>\n                  <jats:tr>\n                    <jats:td align=\"left\" colspan=\"2\">\n                      <jats:bold>Key Points<\/jats:bold>\u2022\u00a0<jats:italic>Almost 20% of rheumatology patients preparing for intensified immunosuppressive therapy were\u00a0<\/jats:italic>\n                      <jats:italic>positive on screening tests for latent tuberculosis infection (LTBI) or showed evidence of exposure to\u00a0<\/jats:italic>\n                      <jats:italic>hepatitis B virus (HBV) or hepatitis C virus (HCV).<\/jats:italic>\u2022\u00a0<jats:italic>All three LTBI assessments (chest X-ray, patient medical history\/self report, and interferon-gamma\u00a0<\/jats:italic>\n                      <jats:italic>release assay) were important in determining LTBI status and seldom overlapped.<\/jats:italic>\u2022\u00a0<jats:italic>Positive results for LTBI, HBV, and HCV were not significantly associated.<\/jats:italic>\u2022\u00a0<jats:italic>Compared with all screened patients, biologic disease-modifying antirheumatic drug (DMARD) use was\u00a0<\/jats:italic>\n                      <jats:italic>lower in patients with a positive LTBI result and targeted synthetic DMARD use was higher, but this\u00a0<\/jats:italic>\n                      <jats:italic>result must be interpreted with caution.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                <\/jats:tbody>\n              <\/jats:table>\n            <\/jats:table-wrap>\n          <\/jats:sec>","DOI":"10.1007\/s10067-025-07350-x","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T10:19:43Z","timestamp":1740478783000},"page":"1851-1859","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Detection of substantial numbers of latent tuberculosis and positive hepatitis B serology results\u00a0in rheumatology patients preparing to receive intensified immunosuppressive therapy in a low-prevalence country: why screening still matters"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8028-8099","authenticated-orcid":false,"given":"Martin","family":"Feuchtenberger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9215-6501","authenticated-orcid":false,"given":"Magdolna Szilvia","family":"Kovacs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5805-806X","authenticated-orcid":false,"given":"Axel","family":"Nigg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6600-3691","authenticated-orcid":false,"given":"Arne","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"key":"7350_CR1","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.1093\/cid\/ciu104","volume":"58","author":"SA Novosad","year":"2014","unstructured":"Novosad SA, Winthrop KL (2014) Beyond tumor necrosis factor inhibition: the expanding pipeline of biologic therapies for inflammatory diseases and their associated infectious sequelae. 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