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P848 Latent tuberculosis and active tuberculosis infection in patients with inflammatory bowel disease treating by biological agents: an experience of a medical centre in Taiwan

H-C. Lai*1, K-S. Cheng2,3, C-H. Chang2, C-L. Feng2, T-W. Chen3,4, J-W. Chou2,3,5

1China Medical University Hospital, Department of Chinese Medicine, Taichung, Taiwan, 2China Medical University Hospital, Division of Gastroenterology and Hepatology, Taichung, Taiwan, 3China Medical University, School of Medicine, Taichung, Taiwan, 4China Medical University Hospital, Department of Pathology, Taichung, Taiwan, 5The Taiwan Society of Inflammatory Bowel Disease, Taipei, Taiwan

Background

Inflammatory bowel disease (IBD) is a chronic and relapsing disease. Comparing with Western countries, low prevalence of IBD and high prevalence of tuberculosis infection were reported in Taiwan. Biological agents are a great advance in treating patients with IBD, but they can increase the risk of tuberculosis (TB) infection. This study was to investigate the incidence rate of latent TB and active TB infection in patients with IBD treating by biological agents.

Methods

From 2000 to 2018, we retrospectively collected patients with IBD treating with biological agents at a tertiary referral centre. All patients underwent a QuantiFERON-TB Gold test to screen for tuberculosis infection before and after biological treatment course. The diagnostic age, gender, cigarette use, types of IBD, chronic hepatitis B/C infection and results of QuantiFERON-TB Gold test were analysed.

Results

One hundred and fifteen patients with IBD receiving biological therapy were enrolled. There were 68 patients with Crohn’s disease, and 47 patients with ulcerative colitis. Male patients were predominance (73%) and the diagnostic mean age of all patients was 37.9 years. Our patients were reported 14% of chronic hepatitis B carrier and no hepatitis C carrier. The results of QuantiFERON-TB Gold test were determinate in 105 cases (91%): nine were positive (8%) and 96 were negative (83%); and indeterminate in 10 cases (9%). Patients with positive results of QuantiFERON-TB Gold test were diagnosed as latent tuberculosis and treated with anti-TB therapy before initiation of the biological agents. Only one patient (0.87%) with ulcerative colitis developed active pulmonary tuberculosis after biological therapy.

Conclusion

Our study demonstrated the incidence of latent tuberculosis is higher than Western countries and similar to Asian countries. However, active tuberculosis infection is low in our participants after receiving biological treatment. Thus, screening and monitoring of TB infection is needed and important for patients with IBD before starting and during biological treatments in Taiwan.