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A SURVEY OF TUBERCULOSIS INFECTION AND ASSOCIATED FACTORS IN PATIENTS ATTENDING THE NATIONAL HOSPITAL OF DERMATOLOGY AND VENEREOLOGY USING THE T-SPOT.TB ASSAY
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Abstract
Tuberculosis infection (TBI) is a condition in which the body mounts a sustained immune response to the presence of Mycobacterium tuberculosis, without clinical signs or symptoms of active tuberculosis. Previously, this condition was commonly referred to as latent tuberculosis infection (TBI). However, the term TBI is gradually being replaced by TBI to better reflect the biological nature of the infection, as the bacteria are not always in a completely dormant state (WHO 2023 & 2024). Most individuals with TBI are asymptomatic but remain at risk of progressing to active tuberculosis, particularly those who are immunocompromised, such as patients with autoimmune diseases or those receiving biologic agents or immunosuppressive therapies. Objective: To determine the prevalence of tuberculosis infection (TBI) and associated factors among patients indicated for T-SPOT.TB testing at the National Hospital of Dermatology and Venereology. Subjects and Methods: A cross-sectional, retrospective study was conducted from July 2023 to June 2024. Patients with an indication for TBI testing by the T-SPOT.TB assay were included. Demographic and clinical data were collected from medical records. Results: Among the 340 patients surveyed, the prevalence of tuberculosis infection (TBI) was 18.8%. Patients with autoimmune diseases had a significantly higher rate of TBI compared to those with other conditions (OR = 2.183; p = 0.014). In addition, patients over 60 years of age had a higher risk of TBI than those under 40 (OR = 2.391; p = 0.017). Other factors such as male gender, self-employment, and a history of exposure to tuberculosis showed a trend toward association with TBI, but did not reach statistical significance. Multivariate logistic regression analysis confirmed that autoimmune disease was an independent and statistically significant factor associated with TBI (OR = 2.3; p = 0.008). Conclusion: TBI remains an important concern in dermatological practice, particularly among elderly patients and those with autoimmune diseases. Routine TBI screening—especially using IGRA methods—should be considered prior to initiating immunosuppressive or biologic therapies in this high-risk population to prevent tuberculosis reactivation and ensure treatment safety.
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Keywords
tuberculosis infection, TBI, T-SPOT.TB, autoimmune diseases, dermatology patients, National Hospital of Dermatology and Venereology
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