Latent tuberculosis: Risk factors, screening and treatment in liver transplantation recipients from an endemic area

doi:10.5500/wjt.v11.i12.512

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 11, Issue 12

This Article

Peer-Review Report of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (9134)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-2) series, Tables (1-2) series.

Item

Count

PDF

318

WORD

123

HTML

3612

Figures (1-2)

539

Tables (1-2)

583

Sum=5175

Featured Article

The chart showing Browse series, Download series.

Item

Count

Browse

417

Download

1392

Sum=1809

Publishing Process of This Article

Item

Count

Browse

597

Download

1550

Sum=2147

Dec 18, 2021 (publication date) through Mar 11, 2026

Times Cited of This Article

Times Cited (4)

Journal Information of This Article

Publication Name

World Journal of Transplantation

ISSN

2220-3230

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

- Full Article with Cover (PDF)
- Full Article (XML)

Retrospective Study

World J Transplant. Dec 18, 2021; 11(12): 512-522
Published online Dec 18, 2021. doi: 10.5500/wjt.v11.i12.512

Latent tuberculosis: Risk factors, screening and treatment in liver transplantation recipients from an endemic area

Isabela Dias Lauar, Luciana Costa Faria, Roberta Maia de Castro Romanelli, Wanessa Trindade Clemente

Isabela Dias Lauar, Medicine Department, Universidade José do Rosário Vellano, Belo Horizonte 31710030, Minas Gerais, Brazil

Luciana Costa Faria, Internal Medicine Department, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30130100, Minas Gerais, Brazil

Roberta Maia de Castro Romanelli, Pediatrics Department, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30130100, Minas Gerais, Brazil

Wanessa Trindade Clemente, Department of Laboratory Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30130100, Minas Gerais, Brazil

Author contributions: Lauar ID, Faria LC, Romanelli RMC and Clemente WT contributed equally to this work in every aspect of study design, data collection and analysis, and manuscript preparation.

Institutional review board statement: The study was approved by the Federal University of Minas Gerais Research Ethics Committee (approval number: 0614.0.203.000-11).

Informed consent statement: All participants provided informed written consent about use of their data in the study and signed the Informed Consent Term.

Conflict-of-interest statement: The authors declare there is no potential conflict-of-interest in this study.

Data sharing statement: No additional data are available.

Corresponding author: Isabela Dias Lauar, MD, Doctor, Professor, Medicine Department, Universidade José do Rosário Vellano, Rua Líbano, 66-Itapoã, Belo Horizonte 31710030, Minas Gerais, Brazil. belalauar@yahoo.com.br

Received: July 26, 2021
Peer-review started: July 26, 2021
First decision: September 2, 2021
Revised: September 25, 2021
Accepted: November 14, 2021
Article in press: November 14, 2021
Published online: December 18, 2021
Processing time: 140 Days and 16.5 Hours

Abstract

BACKGROUND

Patients undergoing solid organ transplantation, particularly those who live or have lived in tuberculosis (TB) endemic areas, are at a high risk of developing TB. The majority of post-transplantation TB cases are associated with reactivation of latent TB infection (LTBI). Brazil is in a single position with overlapping areas of high TB endemicity and high transplant activity. In liver transplant (LT), one should be aware of the potential hepatotoxicity associated with the treatment regimens for LTBI.

AIM

To evaluate the frequency of LTBI in LT patients and treatment-related issues.

METHODS

This was a retrospective analysis of a cohort of cirrhotic patients aged ≥ 18 years, who underwent LT at a high-complexity teaching hospital from January 2005 to December 2012.

RESULTS

Overall, 429 patients underwent LT during the study period. Of these, 213 (49.7%) underwent the tuberculin skin test (TST) during the pre-transplant period, and 35 (16.4%) of them had a positive result. The treatment for LTBI was initiated after LT in 12 (34.3%) of the TST-positive patients; in 3 (25.0%), treatment was maintained for at least 6 mo.

CONCLUSION

The prevalence of LTBI was lower than expected. Initiation and completion of LTBI treatment was limited by difficulties in the management of these special patients.

Keywords: Latent tuberculosis; Liver transplantation; Tuberculosis; Infection; Transplantation; Risk factors

Core Tip: In liver transplant, one should be aware of the potential hepatotoxicity associated with the treatment regimens for latent tuberculosis infection (LTBI). The aim of this study was to evaluate the frequency of LTBI in liver transplant patients and treatment-related issues. The prevalence of LTBI was lower than expected, probably due to low tuberculin skin test sensitivity in patients with impaired liver function. In addition, the initiation and completion of LTBI treatment was limited by difficulties in the management of patients in the presence of elevated liver enzymes and a potential risk of hepatotoxicity.