Prevalence and Risk Factors of Latent Tuberculosis Infection Detected by IGRA in Patients with Immune-Mediated Inflammatory Diseases Before and During Biologic DMARD Therapy (TITAN Study).

: Patients with immune-mediated inflammatory diseases (IMIDs) treated with disease-modifying antirheumatic drugs (DMARDs) are at increased risk of latent tuberculosis infection (LTBI) reactivation, influenced by DMARD type. This study aimed to determine LTBI prevalence using interferon-gamma release assays (IGRAs) and identify associated risk factors in IMID patients in a middle-high TB burden setting in Mexico.: A cross-sectional study was conducted from July 2024 to April 2025 at an IMID clinic. Patients aged &#x2265;18 years, either receiving DMARDs or prior to initiating treatment, were included. LTBI was diagnosed using the QuantiFERON-TB Gold Plus assay. Bivariate analysis was performed using the chi-square test, and multivariate analysis was conducted.: LTBI prevalence was 34.2% (95% CI 29.1-39.7%) according to QFT-Plus and 35.6% (95% CI 29.7-42.0%) according to TSTs (n = 230). Prior TB exposure was the strongest risk factor (aOR 4.20, 95% CI 1.74-10.12,= 0.001), while rheumatoid arthritis was associated with a lower LTBI likelihood (aOR 0.31, 95% CI 0.16-0.59,< 0.001).: A high prevalence of LTBI was observed in patients with IMIDs treated with DMARDs. Prior tuberculosis exposure was strongly associated with LTBI. These findings highlight the importance of LTBI screening in this population to prevent reactivation.