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

Setting-Objective: In this study, it was aimed to reveal the incidence of tuberculosis development in patients receiving tumor necrosis factor-alpha (TNF-cc) blocker therapy, despite tuberculosis chemoprophylaxis.Design: 520 patients who were receiving anti TNF-cc 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-cc 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: pulmo-nary,1: extrapulmonary; 3: UC, 2:AS) who all received anti TNF-cc treatment (0.96%), infliximab. Three patients had tuberculo-sis disease in the 6th month, and the other 2 patients in the 5th and 24th month of their anti TNF-cc 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-cc was found to be higher than the general population. In our country, where tuberculosis is still prevalent, patients receiving Anti TNF-cc treatment (especially in-fliximab) should be carefully questioned and examined about tuberculosis.