Related Experiment Video
Updated: Jun 26, 2026
Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
Published on: April 9, 2012
Latent tuberculosis diagnosis in children by using the QuantiFERON-TB Gold In-Tube test
Jennifer Lighter1, Mona Rigaud, Roger Eduardo
1Department of Pediatrics, New York University School of Medicine, New York, NY 10016, USA.
Insights
The QuantiFERON-TB Gold test shows good specificity for detecting Mycobacterium tuberculosis exposure in children. However, further evaluation is needed to confirm its sensitivity, particularly in children under two years old.
Area of Science:
- Pediatric Infectious Diseases
- Diagnostic Immunology
- Mycobacterial Infections
Background:
- The QuantiFERON-TB Gold In-Tube test is an approved blood test for latent tuberculosis infection.
- Limited data exist on its performance in pediatric populations.
Purpose of the Study:
- To evaluate the performance of the QuantiFERON-TB Gold In-Tube test in children.
- To compare its results with tuberculin skin testing in relation to Mycobacterium tuberculosis exposure.
Main Methods:
- Prospective study of 207 children in New York, New York.
- Assessed risk factors for tuberculosis infection.
- Performed tuberculin skin testing and QuantiFERON-TB Gold In-Tube testing.
- Analyzed concordance and results based on likelihood of exposure.
Main Results:
- Excellent correlation between negative test results.
- Only 23% concordance for positive tuberculin skin test results.
- Positive QuantiFERON-TB Gold In-Tube test results correlated with increased M. tuberculosis exposure.
- Interferon-gamma levels higher in children with recent exposure.
- Performance characteristics were consistent across age groups.
Conclusions:
- The QuantiFERON-TB Gold In-Tube test is specific for M. tuberculosis exposure in children.
- Performance is similar to adults in low-endemic regions.
- Test sensitivity requires further prospective evaluation, especially for children under two years old.
Background:
The QuantiFERON-TB Gold test was the first blood test to be approved for the diagnosis of latent tuberculosis infection. Although it has been shown to be sensitive and specific in adults, limited data on its performance in children are available.
Methods:
This was a prospective study of children receiving health care in New York, New York. Each child was assessed for risk factors for Mycobacterium tuberculosis infection, underwent tuberculin skin testing, and had a QuantiFERON-TB Gold In-Tube test performed. The concordance between tuberculin skin test and QuantiFERON-TB Gold In-Tube test results was calculated, and the results were analyzed according to the likelihood of exposure to M tuberculosis.
Results:
Data for 207 children with valid tuberculin skin test and QuantiFERON-TB Gold In-Tube test results were analyzed. There was excellent correlation between negative tuberculin skin test results and negative QuantiFERON-TB Gold In-Tube test results; however, only 23% of children with positive tuberculin skin test results had positive QuantiFERON-TB Gold In-Tube test results. Positive QuantiFERON-TB Gold In-Tube test results were associated with increased likelihood of M tuberculosis exposure, and interferon gamma levels were higher in children with known recent exposure to M tuberculosis, compared with children with older exposure histories. Younger children produced lower interferon gamma levels in response to the mitogen (phytohemagglutinin) control used in the QuantiFERON-TB Gold In-Tube test, but indeterminant results were low for children of all ages. Performance characteristics were similar across all age groups.
Conclusion:
The QuantiFERON-TB Gold In-Tube test is a specific test for M tuberculosis exposure in children, with performance characteristics similar to those for adults residing in regions with low levels of endemic disease. Concerns about test sensitivity, especially for children <2 years of age, will require additional prospective long-term evaluation.
Related Concept Videos
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...