Tuberculosis infection in BCG vaccinated children and adolescents with rheumatological diseases treated by tumor necrosis factor-α inhibitors
European Journal of Pediatrics, cilt.185, sa.6, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 185 Sayı: 6
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00431-026-07028-9
- Dergi Adı: European Journal of Pediatrics
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE
- Anahtar Kelimeler: Adolescents, BCG, Children, Latent tuberculosis infection, Tuberculosis, Tumor necrosis factor-alpha inhibitors
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Hacettepe Üniversitesi Adresli: Evet
Özet
Abstract: Tumor necrosis factor-alpha (TNF-α) inhibitors increase the risk of developing active tuberculosis (TB) disease through reactivation of latent TB infection (LTBI). We aimed to analyze TB infections in BCG-vaccinated children and adolescents with rheumatologic diseases treated with TNF-α inhibitors in a country of moderate risk for TB. This retrospective study included 261 children with a rheumatic disease who were treated with TNF-α inhibitors and followed up on a fixed schedule between January 2018 and December 2022. Demographic and clinical characteristics, as well as TB screening results, were recorded. The mean age of the patients was 14.0 ± 4.1 years; 56.7% were female. The mean age at initiation of TNF-α inhibitors was 11.0 ± 5.1 years, the mean duration of TNF-α inhibitor use was 4.1 ± 2.7 years, and the mean follow-up time was 4.1 ± 2.6 years. During the study period, 75 (29.0%) patients were diagnosed with LTBI: 44% at the initial evaluation and 56% during follow-up. None of them progressed to TB disease. Only two cases of active TB disease were seen without prior documented LTBI. Age and duration of TNF-α inhibitor use were significantly associated with LTBI positivity. Conclusion: TB screening is necessary in children and adolescents at the initiation of and during TNF-α inhibitor therapy. The risk of LTBI positivity increases with age and longer use of TNF-α inhibitors. No cases progressed from LTBI to active TB, which may support the effectiveness of current screening and prophylaxis strategies in our country. (Table presented.)