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Published on: July 11, 2015
Interferon-γ release assay for the diagnosis of tuberculosis in children
Ana Méndez-Echevarría1, Miguel González-Muñoz, Maria Jose Mellado
1Paediatric Department, La Paz Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain. amendezes@yahoo.es
Insights
The QuantiFERON-TB GOLD In Tube (QTF) test and tuberculin skin test (TST) showed excellent agreement in children with TB disease or no infection. However, QTF had more negative results in latent TB infection cases, especially in BCG-vaccinated children.
Area of Science:
- Pediatric infectious diseases
- Diagnostic immunology
- Tuberculosis research
Background:
- Tuberculosis (TB) diagnosis in children presents unique challenges.
- Interferon-gamma release assays (IGRAs) like QuantiFERON-TB GOLD In Tube (QTF) and tuberculin skin tests (TST) are used to detect TB infection.
- Comparative effectiveness of these tests in pediatric populations requires further investigation.
Purpose of the Study:
- To compare the diagnostic performance of the QuantiFERON-TB GOLD In Tube (QTF) test and the tuberculin skin test (TST) in a pediatric cohort.
- To evaluate the agreement between QTF and TST across different pediatric groups, including those with latent TB infection (LTBI), TB disease (TBD), and no infection.
Main Methods:
- A prospective study conducted in nine hospitals in Madrid, Spain.
- TST and QTF tests were administered to 459 children, including immigrants, TB contacts, and patients with TB disease.
- Data analysis focused on agreement rates and factors influencing discrepancies between the two tests.
Main Results:
- Overall agreement between QTF and TST was excellent in children with TB disease (TBD) and those without infection (0.8% disagreement).
- Disagreement was significantly higher in children with latent TB infection (LTBI) (54% disagreement).
- BCG vaccination status and TB exposure influenced test agreement, with lower agreement in BCG-vaccinated children and better agreement in TB-exposed individuals.
Conclusions:
- QTF and TST demonstrate excellent agreement in pediatric TB disease and non-infected cases.
- A notable proportion of false-negative QTF results were observed in LTBI cases, particularly among BCG-vaccinated children.
- TB exposure status positively impacts the agreement between QTF and TST in children.
Aims:
To compare the QuantiFERON-TB GOLD In Tube test (QTF) and the tuberculin skin test (TST) in children.
Methods:
A prospective study was carried out in nine hospitals in Madrid, Spain. TST and QTF were performed in immigrants, tuberculosis (TB) contacts and patients with TB disease (TBD).
Results:
459 children were included. Disagreement between the tests was more frequently observed among latent tuberculosis infection (LTBI) cases (54%; 38/70) than in non-infected or TBD cases (0.8%; 3/369) (p<0.01). There were more BCG-vaccinated children among LTBI cases with negative QTF (76%) than among LTBI cases with positive QTF (40%) (p<0.001). Agreement between tests in BCG-vaccinated children was lower than in non-vaccinated cases (p<0.05). Tests in TB exposed patients showed better agreement than in non-exposed children (p<0.05).
Conclusions:
Agreement of both tests was excellent in TBD cases, non-vaccinated children and non-infected patients. A significant number of QTF negative results were observed among LTBI cases, especially in BCG-vaccinated children. Agreement was better in exposed children.
