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Sensitivity and characteristics associated with positive QuantiFERON-TB Gold-Plus assay in children with confirmed

Duc T Nguyen1, Ha Phan2,3, Trang Trinh2

  • 1Houston Methodist Research Institute, Houston, TX, United States of America.

Plos One
|March 5, 2019
PubMed

Insights

The QuantiFERON-TB Gold Plus (QFT-Plus) assay shows good sensitivity for pulmonary tuberculosis (TB) in children but poor sensitivity for extra-pulmonary TB (EPTB). Further research is needed to improve pediatric TB diagnostics.

Area of Science:

  • Pediatric infectious diseases
  • Tuberculosis diagnostics
  • Immunological assays

Background:

  • The QuantiFERON-TB Gold Plus (QFT-Plus) is a newer interferon-gamma release assay for TB detection.
  • Limited data exists on QFT-Plus performance in pediatric populations.

Purpose of the Study:

  • To evaluate the performance of the QFT-Plus assay in children suspected of having tuberculosis (TB).
  • To determine the sensitivity of QFT-Plus in different forms of pediatric TB, including pulmonary TB (PTB) and extra-pulmonary TB (EPTB).

Main Methods:

  • Retrospective analysis of de-identified data from 222 TB-suspected children (<18 years) tested with QFT-Plus.
  • Logistic regression used to identify factors associated with positive QFT-Plus results.
  • Calculation of QFT-Plus sensitivity for overall TB, PTB only, EPTB only, and combined PTB/EPTB.

Main Results:

  • Of 222 children, 33 had confirmed TB (18 QFT-Plus positive, 15 negative).
  • Age, TB history, and confirmed TB status were associated with positive QFT-Plus results (AUC=0.77).
  • QFT-Plus sensitivity was 84.2% for PTB only, but only 14.3% for EPTB and 14.3% for combined PTB/EPTB. Overall sensitivity was 54.5%.

Conclusions:

  • QFT-Plus demonstrates good sensitivity for diagnosing pulmonary TB in children.
  • The assay exhibits poor sensitivity for diagnosing extra-pulmonary TB in pediatric patients.
  • QFT-Plus performance varies significantly depending on TB localization in children.
Abstract

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