The Association between QuantiFERON-TB Gold Test and Clinical Manifestations of Uveitis in the United States

Abstract

Purpose: To report the prevalence of QuantiFERON-TB Gold (QFT-G) positivity among uveitis patients compared to general population and to evaluate the differences in clinical features of uveitis.

Design: Retrospective cohort study.

Methods: SETTING: Institutional.

Patient population: 418 consecutive new uveitis patients, regardless of clinical suspicion, were tested for QFT-G.

Observation procedures: Demographics, TB risk factors, clinical characteristics of uveitis were collected.

Main outcome measures: The frequency of QFT-G positivity among uveitis patients and characteristic clinical features among QFT-G positive patients.

Results: QFT-G positivity was found in 60/418 patients with uveitis (14.4%, 95% CI: 11.18 - 18.14) higher than the general US population (5%, 95% CI: 4.2 - 5.8, p<.001). Age, gender and residence were similar between QFT-G positive and negative groups. Uveitis patients with positive QFT-G were more likely to be foreign born or have a recent travel history (OR:5.84; 95% CI: 2.83 - 12.05; p<.001). QFT-G positive patients were more likely to present with granulomatous uveitis (OR 2.90; 95%CI 1.36 - 6.21; p=.006). No significant association was found with specific clinical features such as choroiditis, retinal vasculitis, occlusive vasculitis, and serpiginoid choroiditis (p>.05 for each). Prevalence of TB-uveitis based on treatment response was 1.19%.

Conclusions: Our study demonstrates significantly higher prevalence of QFT-G positivity among uveitis patients compared to average US population. Characteristic signs of TB uveitis reported in endemic countries were not seen in this cohort. Implications of higher prevalence of QFT-G positivity among uveitis patients require further investigation.