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A comparison of interferon-γ and IP-10 for the diagnosis of tuberculosis

Line Lindebo Holm1, Michala Vaaben Rose2, Godfather Kimaro3

  • 1Clinical Research Centre, and Departments of Paediatrics and line.lindebo.holm@gmail.com.

Pediatrics
|November 26, 2014
PubMed

Insights

Interferon-γ (IP-10) and QuantiFERON-TB Gold In-tube (QFT-IT) assays showed poor accuracy for diagnosing active tuberculosis in Tanzanian children. Performance was compromised in young children, making them unsuitable for this population in high-burden settings.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Pediatric Medicine

Background:

  • Tuberculosis (TB) diagnosis in children remains challenging, particularly in high-burden settings.
  • Interferon-γ (IFN-γ) release assays, including IP-10 and QuantiFERON-TB Gold In-tube (QFT-IT), are used to detect TB infection.
  • Evaluating the diagnostic accuracy of these tests in pediatric populations is crucial.

Purpose of the Study:

  • To compare the diagnostic accuracy of IP-10 and QFT-IT assays for active tuberculosis in hospitalized Tanzanian children.
  • To assess the impact of age and other factors on test performance in children.

Main Methods:

  • A comparative diagnostic accuracy study was conducted in hospitalized Tanzanian children suspected of active TB.
  • Children were tested using both IP-10 and QFT-IT assays.
  • Adults with confirmed TB were assessed in parallel for comparison.

Main Results:

  • The study included 203 children, with a median age of 3.0 years; 38% were HIV-infected, and 36% were under 2 years old.
  • Both IP-10 and QFT-IT showed low sensitivity in children (33% and 29% for confirmed/probable TB, respectively) but comparable performance in adults (80%).
  • High rates of indeterminate results were observed (29% for IP-10, 26% for QFT-IT), particularly in children under 2 years.

Conclusions:

  • IP-10 and QFT-IT assays demonstrated poor performance in diagnosing active TB in hospitalized Tanzanian children.
  • Test accuracy was significantly compromised in younger children (<2 years) and associated with high indeterminate rates.
  • These IFN-γ release assays cannot be recommended for diagnosing active TB in hospitalized children in TB-endemic regions.
Abstract

Keywords:
IP-10childrendiagnosisinterferon-γ release assaytuberculosis

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