{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:59:59Z","timestamp":1792799999690,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Research Laboratory in Immunology of Renal Transplantation and Immunopathology","award":["LR03SP01"],"award-info":[{"award-number":["LR03SP01"]}]},{"name":"Charles Nicolle Hospital, Tunis El Manar University, Tunisia","id":[{"id":"https:\/\/ror.org\/029cgt552","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medicine"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Screening for latent tuberculosis infection using Interferon-Gamma Release Assays is a routine procedure prior to the initiation of anti-tumor necrosis factor (TNF) biotherapy or immunosuppressive therapy. However, indeterminate results are relatively frequent and are an obstacle to treatment initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>\n                      The aim of this cross-sectional study was to estimate the frequency of indeterminate QuantiFERON-TB Gold Plus\n                      <jats:sup>\u00ae<\/jats:sup>\n                      test results in Tunisian patients, and to analyze the potential clinico-biological risk factors associated with these indeterminate results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Whole blood samples from 712 patients being monitored for autoimmune diseases and candidates for anti-TNF biotherapy or switch of immunosuppressive therapy were used to screen for latent tuberculosis infection using the QuantiFERON-TB Gold Plus\n                      <jats:sup>\u00ae<\/jats:sup>\n                      test. Based on literature background, the following variables were tested for the association with indeterminate results: gender, age, diabetes, immunosuppressive drugs, lymphocyte count, Neutrophil-to-lymphocyte ratio, serum albumin, and estimated glomerular filtration rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The QuantiFERON-TB Gold Plus\n                      <jats:sup>\u00ae<\/jats:sup>\n                      test was negative in 572 (80.3%) patients, positive in 106 (14.9%), and indeterminate in 34 (4.8%) cases. Positive results were significantly associated with a family history of confirmed and treated tuberculosis, OR (95% CI)\u2009=\u200952 (20.2\u2013134.3). The use of immunosuppressive drugs and duration of treatment were significantly associated with the occurrence of indeterminate results: OR (95% CI)\u2009=\u200924.5 (5.8\u2013103) and OR (95% CI)\u2009=\u20091.004 (1.002\u20131.007), respectively. Biologically, lymphopenia, hypoalbuminemia, and decreased estimated glomerular filtration rate were significant risk factors for indeterminate results: p\u2009=\u20095 E-6, p\u2009=\u20094.3 E-4, and p\u2009=\u20090.002, respectively. Thus, a multiple logistic regression model based on these three biological parameters enabled us to develop a predictive score for indeterminate results with a sensitivity of 91.2% and a specificity of 99.9%, AUC\u2009=\u20090.9964 (0.9917\u20131), p\u2009=\u20092.8 E-52.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Immunosuppressive therapy, lymphopenia, hypoalbuminemia, and kidney failure appeared to be risk factors for indeterminate QuantiFERON-TB Gold Plus\n                      <jats:sup>\u00ae<\/jats:sup>\n                      results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121241279116","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T09:30:19Z","timestamp":1725960619000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["A regression predictive model for QuantiFERON-TB Gold Plus\n                    <sup>\u00ae<\/sup>\n                    indeterminate results in immunosuppressed patients"],"prefix":"10.1177","volume":"12","author":[{"given":"Rahma","family":"Bellagha","sequence":"first","affiliation":[{"name":"Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6376-0950","authenticated-orcid":false,"given":"Tarak","family":"Dhaouadi","sequence":"additional","affiliation":[{"name":"Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awatef","family":"Riahi","sequence":"additional","affiliation":[{"name":"Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wahiba","family":"Ben Rehouma","sequence":"additional","affiliation":[{"name":"Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajer","family":"Jedidi","sequence":"additional","affiliation":[{"name":"Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Mouelhi","sequence":"additional","affiliation":[{"name":"Department of Gastro-Enterology, Charles Nicolle Hospital, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Abdelmoula","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ta\u00efeb","family":"Ben Abdallah","sequence":"additional","affiliation":[{"name":"Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousr","family":"Gorgi","sequence":"additional","affiliation":[{"name":"Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imen","family":"Sfar","sequence":"additional","affiliation":[{"name":"Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"key":"bibr1-20503121241279116","unstructured":"World Health Organization. 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