Possibilities of diagnosing latent tuberculosis infection using recombinant tuberculosis allergen in patients with rheumatological diseases

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Abstract

Background. Against the background of the therapeutic effectiveness of genetically engineered biological preparations (GEBPs) that affect immune cells, patients with rheumatological diseases increase the risk of developing tuberculosis infection.

Objective. Evaluation of the role of immunodiagnostics and the results of a test with the recombinant tuberculosis allergen (RTA) in the detection of latent tuberculosis infection in rheumatological patients undergoing biological therapy.

Methods. 26 outpatient records of patients in the Omsk district of the Omsk region for 2020–2023, receiving biological therapy for the treatment of rheumatological diseases were analyzed, and the prevalence of tuberculosis infection among these patients was assessed.

Results. Of the 26 patients, latent tuberculosis infection was diagnosed in 5 (19.23%) patients based on the examination. In 4 out of 5 patients, the RTA test was positive: a moderate reaction in 2 – 6 and 9 mm, a pronounced reaction in 1 – 14 mm, a hyperergic reaction in 1 patient – 15 mm, 1 patient – doubtful. By decision of the Central Medical Commission of the Clinical Tuberculosis Dispensary, patients were given a preventive course of anti-tuberculosis therapy. During the follow-up period, the study group managed to avoid the development of active tuberculosis infection and continue treatment of the underlying disease using genetic engineering biological therapy.

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About the authors

A. V. Mordyk

Omsk State Medical University; National Medical Research Center for Phthisiopulmonology and Infectious Diseases

Email: ppi100@mail.ru
ORCID iD: 0000-0001-6196-7256
Russian Federation, Omsk; Moscow

M. A. Romanova

Omsk State Medical University

Email: ppi100@mail.ru
ORCID iD: 0000-0002-1775-607X
Russian Federation, Omsk

A. I. Nurgaleeva

Omsk State Medical University

Email: ppi100@mail.ru
Russian Federation, Omsk

Natalya V. Bagisheva

Omsk State Medical University

Author for correspondence.
Email: ppi100@mail.ru
ORCID iD: 0000-0003-3668-1023

Cand. Sci. (Med.), Associate Professor, Department of Outpatient Therapy and Internal Medicine

Russian Federation, Omsk

A. A. Shapran

Omsk Central District Hospital

Email: ppi100@mail.ru
ORCID iD: 0009-0008-6729-7116
Russian Federation, Omsk

M. V. Moiseeva

Omsk State Medical University

Email: ppi100@mail.ru
ORCID iD: 0000-0003-3458-9346
Russian Federation, Omsk

L. E. Shcherbakova

Omsk State Medical University

Email: ppi100@mail.ru
Russian Federation, Omsk

A. I. Mazur

Omsk State Medical University

Email: ppi100@mail.ru
Russian Federation, Omsk

P. S. Shatova

Omsk State Medical University

Email: ppi100@mail.ru
Russian Federation, Omsk

D. I. Mordyk

Main Bureau of Medical and Social Assessment for the Omsk Region, Branch No. 17

Email: ppi100@mail.ru
Russian Federation, Omsk

D. A. Kudlay

I.M. Sechenov First Moscow State Medical University (Sechenov University); State Scientific Center “Institute of Immunology of the Federal Medical and Biological Agency”; Lomonosov Moscow State University

Email: ppi100@mail.ru
Russian Federation, Moscow; Moscow; Moscow

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Supplementary files

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2. Fig. 1. Distribution of patients receiving GIBP by gender and age (n=2b)

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3. Fig. 2. The frequency of occurrence of various RS in the observed patients (n=2b)

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4. Fig. 3. Distribution of patients with LT depending on gender, age and nature of nosology (n=5)

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