Frequency of latent tuberculosis in patients receiving Anti-TNF-Alpha therapy

Coşkunol İ., Turan O., Baysak A. G., Solmaz D., CAN G.

African Health Sciences, vol.23, no.2, pp.128-132, 2023 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 23 Issue: 2
  • Publication Date: 2023
  • Doi Number: 10.4314/ahs.v23i2.14
  • Journal Name: African Health Sciences
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, Index Islamicus, MEDLINE, Pollution Abstracts, Veterinary Science Database
  • Page Numbers: pp.128-132
  • Keywords: Anti-TNF-alpha, tuberculin skin test, tuberculosis
  • Istanbul Medipol University Affiliated: Yes


Setting-Objective: In this study, it was aimed to reveal the incidence of tuberculosis development in patients receiving tumor necrosis factor-alpha (TNF-α) blocker therapy, despite tuberculosis chemoprophylaxis. Design: 520 patients who were receiving anti TNF-α treatment in the last 3 years were evaluated retrospectively. Radiological imaging tuberculin skin test (TST), history of tuberculosis, BCG vaccine, chemoprophylaxis administration, used anti TNF-α drugs were recorded. Results: There were 265(51.0%) of the patients with ankylosing spondylitis (AS), 175(33.7%) with rheumatoid arthritis, 35(6.7%) with Crohn's, 10(1.9%) with ulcerative colitis (UC), 21(4.0%) with psoriatic arthritis, 14(2.7%) with psoriasis vulgaris. In total, 455 (79.6%) patients were given INH prophylaxis. Active tuberculosis development was observed in five patients (4: pulmonary,1: extrapulmonary; 3: UC, 2:AS) who all received anti TNF-α treatment (0.96%), infliximab. Three patients had tuberculosis disease in the 6th month, and the other 2 patients in the 5th and 24th month of their anti TNF-α treatments, and two had 9-month, and 1 had 6-month chemoprophylaxis history. Conclusion: The incidence of tuberculosis development in patients treated with anti TNF-α was found to be higher than the general population. In our country, where tuberculosis is still prevalent, patients receiving Anti TNF-α treatment (especially in-fliximab) should be carefully questioned and examined about tuberculosis.