{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:24:53Z","timestamp":1791415493281,"version":"4.3.3"},"reference-count":47,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2021R1C1C1005728"],"award-info":[{"award-number":["NRF-2021R1C1C1005728"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Screening for latent tuberculosis infection (LTBI) is mandatory before commencing tumor necrosis factor (TNF)-\u03b1 inhibitor use. However, the impact of immunosuppressive therapy (IST), including corticosteroids and immunomodulators, on the performance of LTBI screening in patients with inflammatory bowel disease (IBD) has not been fully elucidated. We searched all relevant studies published before November 2021 that examined the performance of interferon \u03b3 release assays (IGRAs) and tuberculin skin tests (TSTs) in patients with IBD who received IST, using the Medline, EMBASE, and Cochrane Library databases. We performed meta-analyses of positive or indeterminate rates of IGRA or TST according to IST and calculated the concordance rates between IGRA and TST results. A total of 20 studies with 4045 patients were included in the meta-analysis. The IGRA-positive rate was lower in patients on IST than in those not on IST (odds ratio (OR) (95% confidence interval (CI)) = 0.55 (0.39\u20130.78)), whereas the IGRA-indeterminate rate was higher in patients on IST than in those not on IST (OR (95% CI) = 2.91 (1.36\u20136.24)). The TST-positive rate did not differ between the on-IST and not-on-IST groups (OR (95% CI) = 0.87 (0.51\u20131.50)). The concordance rate between IGRA and TST was 83.3% (95% CI, 78.5\u201388.1%). The IGRA-negative\/TST-positive rate tended to be higher than that the IGRA-positive\/TST-negative rate (9.5% vs. 5.8%, respectively), although the difference was not statistically significant. In conclusion, IGRA results were negatively affected by IST in patients with IBD, supporting requirements that IGRA should be performed before initiating IST. The use of both an IGRA and TST in patients with IBD on IST may improve the diagnosis rate of LTBI.<\/jats:p>","DOI":"10.3390\/jpm12030507","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T21:48:42Z","timestamp":1647899322000},"page":"507","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3824-3481","authenticated-orcid":false,"given":"Chan Hyuk","family":"Park","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Ho","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1963-7170","authenticated-orcid":false,"given":"Yoon Suk","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.5217\/ir.2018.16.1.4","article-title":"Asian organization for crohn\u2019s and colitis and asia pacific association of gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: Risk assessment","volume":"16","author":"Park","year":"2018","journal-title":"Intest. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3472","DOI":"10.4049\/jimmunol.1003299","article-title":"Multiscale computational modeling reveals a critical role for tnf-\u03b1 receptor 1 dynamics in tuberculosis granuloma formation","volume":"186","author":"Marino","year":"2011","journal-title":"J. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1128\/IAI.69.3.1847-1855.2001","article-title":"Effects of tumor necrosis factor alpha on host immune response in chronic persistent tuberculosis: Possible role for limiting pathology","volume":"69","author":"Mohan","year":"2001","journal-title":"Infect. Immun."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5217\/ir.2019.09146","article-title":"Efficacy of biologic therapies for biologic-na\u00efve japanese patients with moderately to severely active ulcerative colitis: A network meta-analysis","volume":"19","author":"Hibi","year":"2021","journal-title":"Intest. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"323","DOI":"10.5217\/ir.2020.00039","article-title":"Long-term outcomes of infliximab in a real-world multicenter cohort of patients with acute severe ulcerative colitis","volume":"19","author":"Oh","year":"2021","journal-title":"Intest. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1056\/NEJMoa011110","article-title":"Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent","volume":"345","author":"Keane","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s10067-014-2817-6","article-title":"Screening of latent tuberculosis infection by interferon-\u03b3 release assays in rheumatic patients: A systemic review and meta-analysis","volume":"35","author":"Ruan","year":"2016","journal-title":"Clin. Rheumatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"177","DOI":"10.7326\/0003-4819-149-3-200808050-00241","article-title":"Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: An update","volume":"149","author":"Pai","year":"2008","journal-title":"Ann. Intern. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"340","DOI":"10.7326\/0003-4819-146-5-200703060-00006","article-title":"Meta-analysis: New tests for the diagnosis of latent tuberculosis infection: Areas of uncertainty and recommendations for research","volume":"146","author":"Menzies","year":"2007","journal-title":"Ann. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1136\/ard.2007.070789","article-title":"Detection of latent tuberculosis in immunosuppressed patients with autoimmune diseases: Performance of a mycobacterium tuberculosis antigen-specific interferon gamma assay","volume":"67","author":"Matulis","year":"2008","journal-title":"Ann. Rheum. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1183\/09031936.00013409","article-title":"Impaired detection of Mycobacterium tuberculosis immunity in patients using high levels of immunosuppressive drugs","volume":"34","author":"Sester","year":"2009","journal-title":"Eur. Respir. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1002\/ibd.22901","article-title":"Performance of interferon-gamma release assays in patients with inflammatory bowel disease: A systematic review and meta-analysis","volume":"18","author":"Shahidi","year":"2012","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"306","DOI":"10.5217\/ir.2019.00116","article-title":"Concordance between tuberculin skin test and interferon-gamma release assay for latent tuberculosis screening in inflammatory bowel disease","volume":"18","author":"Alrajhi","year":"2020","journal-title":"Intest. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the newcastle-ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur. J. Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/cid\/ciw778","article-title":"Official american thoracic society\/infectious diseases society of america\/centers for disease control and prevention clinical practice guidelines: Diagnosis of tuberculosis in adults and children","volume":"64","author":"Lewinsohn","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"ref_18","unstructured":"Higgins, J., and Green, S. (2021, November 21). Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0. Available online: https:\/\/handbook-5-1.cochrane.org\/."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jclinepi.2009.06.006","article-title":"The prisma statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration","volume":"62","author":"Liberati","year":"2009","journal-title":"J. Clin. Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v036.i03","article-title":"Conducting meta-analyses in r with the metafor package","volume":"36","author":"Viechtbauer","year":"2010","journal-title":"J. Stat. Softw."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","article-title":"How to perform a meta-analysis with r: A practical tutorial","volume":"22","author":"Balduzzi","year":"2019","journal-title":"Evid. Based Ment. Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1111\/j.1572-0241.2008.02050.x","article-title":"Comparison of interferon-gamma release assay versus tuberculin skin test for tuberculosis screening in inflammatory bowel disease","volume":"103","author":"Schoepfer","year":"2008","journal-title":"Am. J. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1002\/ibd.21427","article-title":"Factors impacting the results of interferon-\u03b3 release assay and tuberculin skin test in routine screening for latent tuberculosis in patients with inflammatory bowel diseases","volume":"17","author":"Papay","year":"2011","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/ibd.21329","article-title":"Quantiferon tb gold testing for tuberculosis screening in an inflammatory bowel disease cohort in the united states","volume":"17","author":"Qumseya","year":"2011","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1136\/annrheumdis-2011-200408","article-title":"Influence of replacing tuberculin skin test with ex vivo interferon \u03b3 release assays on decision to administer prophylactic antituberculosis antibiotics before anti-tnf therapy","volume":"71","author":"Mariette","year":"2012","journal-title":"Ann. Rheum. Dis."},{"key":"ref_26","first-page":"21","article-title":"Comparison of quantiferon-tb gold versus tuberculin skin test for tuberculosis screening in inflammatory bowel disease patients","volume":"22","author":"Andrisani","year":"2013","journal-title":"J. Gastrointest. Liver Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.crohns.2012.08.010","article-title":"Yield and cost effectiveness of mycobacterial infection detection using a simple igra-based protocol in uk subjects with inflammatory bowel disease suitable for anti-tnf\u03b1 therapy","volume":"7","author":"Greveson","year":"2013","journal-title":"J. Crohns Colitis"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s10238-012-0192-7","article-title":"Negative effect of immunosuppressive therapy in the performance of the quantiferon gold in-tube test in patients with immune-mediated inflammatory diseases","volume":"13","author":"Ramos","year":"2013","journal-title":"Clin. Exp. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1097\/01.MIB.0000438429.38423.62","article-title":"T-cell profiling and the immunodiagnosis of latent tuberculosis infection in patients with inflammatory bowel disease","volume":"20","author":"Riestra","year":"2014","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1097\/MIB.0000000000000147","article-title":"Performance of interferon-gamma release assay for tuberculosis screening in inflammatory bowel disease patients","volume":"20","author":"Wong","year":"2014","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_31","first-page":"241","article-title":"Latent tuberculosis screening tests and active tuberculosis infection rates in turkish inflammatory bowel disease patients under anti-tumor necrosis factor therapy","volume":"28","author":"Aslan","year":"2015","journal-title":"Ann. Gastroenterol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.3109\/00365521.2015.1064470","article-title":"The impact of immunosuppressive therapy on quantiferon and tuberculin skin test for screening of latent tuberculosis in patients with inflammatory bowel disease scheduled for anti-tnf therapy","volume":"50","author":"Mantzaris","year":"2015","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/j.dld.2016.08.107","article-title":"The tuberculin skin test still matters for the screening of latent tuberculosis infections among inflammatory bowel disease patients","volume":"48","author":"Abreu","year":"2016","journal-title":"Dig. Liver Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/1751-2980.12437","article-title":"Tuberculosis screening using igra and chest computed tomography in patients with inflammatory bowel disease: A retrospective study","volume":"18","author":"Song","year":"2017","journal-title":"J. Dig. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1093\/ecco-jcc\/jjx022","article-title":"Early tuberculin skin test for the diagnosis of latent tuberculosis infection in patients with inflammatory bowel disease","volume":"11","author":"Taxonera","year":"2017","journal-title":"J. Crohns Colitis"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1093\/ibd\/izx019","article-title":"Indeterminate quantiferon-tb gold increases likelihood of inflammatory bowel disease treatment delay and hospitalization","volume":"24","author":"Vajravelu","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2695","DOI":"10.1007\/s10620-018-5178-1","article-title":"A study of optimal screening for latent tuberculosis in patients with inflammatory bowel disease","volume":"63","author":"Strohl","year":"2018","journal-title":"Dig. Dis. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"292","DOI":"10.5152\/tjg.2018.17162","article-title":"Screening for latent tuberculosis infection in patients with inflammatory bowel disease: Can interferon-gamma release assays replace the tuberculin skin test?","volume":"29","author":"Cabriada","year":"2018","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1136\/flgastro-2017-100951","article-title":"Challenges in screening for latent tuberculosis in inflammatory bowel disease prior to biologic treatment: A uk cohort study","volume":"9","author":"Thi","year":"2018","journal-title":"Frontline Gastroenterol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1007\/s10620-019-5475-3","article-title":"Superiority of interferon gamma assay over tuberculin skin test for latent tuberculosis in inflammatory bowel disease patients in brazil","volume":"64","author":"Amorim","year":"2019","journal-title":"Dig. Dis. Sci."},{"key":"ref_41","first-page":"6682840","article-title":"Comparison of interferon-gamma release assay and tuberculin skin test for the screening of latent tuberculosis in inflammatory bowel disease patients: Indian scenario","volume":"2021","author":"Mantri","year":"2021","journal-title":"Tuberc. Res. Treat."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1136\/thoraxjnl-2015-207811","article-title":"Effect of immunosuppressive therapy on interferon \u03b3 release assay for latent tuberculosis screening in patients with autoimmune diseases: A systematic review and meta-analysis","volume":"71","author":"Wong","year":"2016","journal-title":"Thorax"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Auguste, P., Tsertsvadze, A., Pink, J., Court, R., McCarthy, N., Sutcliffe, P., and Clarke, A. (2017). Comparing interferon-gamma release assays with tuberculin skin test for identifying latent tuberculosis infection that progresses to active tuberculosis: Systematic review and meta-analysis. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2301-4"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"11","DOI":"10.5217\/ir.2020.00155","article-title":"Use of thiopurines in inflammatory bowel disease: An update","volume":"20","author":"Singh","year":"2021","journal-title":"Intest. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"186","DOI":"10.5217\/ir.2020.00028","article-title":"Temporal trend in the natural history of ulcerative colitis in a country with a low incidence of ulcerative colitis from 2000 through 2018","volume":"19","author":"Aniwan","year":"2021","journal-title":"Intest. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"428","DOI":"10.5588\/ijtld.13.0644","article-title":"The \u2018either test positive\u2019 strategy for latent tuberculous infection before anti-tumour necrosis factor treatment","volume":"18","author":"Jung","year":"2014","journal-title":"Int. J. Tuberc. Lung. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e022445","DOI":"10.1136\/bmjopen-2018-022445","article-title":"Screening and prevention for latent tuberculosis in immunosuppressed patients at risk for tuberculosis: A systematic review of clinical practice guidelines","volume":"8","author":"Hasan","year":"2018","journal-title":"BMJ Open"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/3\/507\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:40:28Z","timestamp":1760136028000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/3\/507"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,21]]},"references-count":47,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jpm12030507"],"URL":"https:\/\/doi.org\/10.3390\/jpm12030507","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,21]]}}}