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13-02-2024 | Tuberculosis | Research

Safety and outcome of treatment of latent tuberculosis infection in liver transplant recipients

Authors: Yun Woo Lee, Hyemin Chung, Sung-Han Kim, Heungsup Sung, Su-Min Ha, Eun-Kyoung Jwa, Dong-Hwan Jung, Deok-Bog Moon, Sung-Gyu Lee, Sang-Oh Lee

Published in: Infection

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Abstract

Purpose

Liver transplant (LT) recipients have an increased risk of tuberculosis (TB), which is associated with higher mortality rates. This retrospective cohort study assessed the outcome and tolerability of screening and treatment of latent tuberculosis infection (LTBI) in LT recipients.

Methods

Between March 2020 and February 2022, all adult LT candidates at our institution were screened for LTBI. The candidates who tested positive for interferon-γ-releasing assay or met epidemiological or clinical-radiological criteria for LTBI were treated and monitored.

Results

Among the 857 LT recipients, 199 (23.2%) were diagnosed with LTBI, of which 171 (85.9%) initiated LTBI treatment. The median duration of follow-up was 677 days. Adequate LTBI treatment occurred in 141/171 (82.5%) patients and was discontinued prematurely in 30/171 (17.5%) patients. The most common reason for discontinuation was liver enzyme elevation (11/30, 36.7%), although only five discontinued treatment due to suspicion of isoniazid-associated hepatotoxicity. None of the LTBI-treated patients developed active TB during the follow-up period, while 3.6% (1/28) of untreated LTBI patients and 0.6% (4/658) of patients without LTBI developed TB.

Conclusion

These findings demonstrate that LTBI screening and treatment is a safe and effective strategy to prevent TB in LT recipients. However, monitoring for adverse events and liver enzyme elevation is recommended.
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Literature
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go back to reference Olithselvan A, Rajagopala S, Vij M, Shanmugam V, Shanmugam N, Rela M. Tuberculosis in liver transplant recipients: experience of a South Indian liver transplant center. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc. 2014;20:960–6. https://doi.org/10.1002/lt.23903.CrossRef Olithselvan A, Rajagopala S, Vij M, Shanmugam V, Shanmugam N, Rela M. Tuberculosis in liver transplant recipients: experience of a South Indian liver transplant center. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc. 2014;20:960–6. https://​doi.​org/​10.​1002/​lt.​23903.CrossRef
24.
Metadata
Title
Safety and outcome of treatment of latent tuberculosis infection in liver transplant recipients
Authors
Yun Woo Lee
Hyemin Chung
Sung-Han Kim
Heungsup Sung
Su-Min Ha
Eun-Kyoung Jwa
Dong-Hwan Jung
Deok-Bog Moon
Sung-Gyu Lee
Sang-Oh Lee
Publication date
13-02-2024
Publisher
Springer Berlin Heidelberg
Published in
Infection
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-023-02161-1
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