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Borderline-Positive Quantiferon in Children

Ulrikka Nygaard1, Anja Poulsen1, Alex Yde Nielsen2

  • 1Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Denmark.

The Pediatric Infectious Disease Journal
|July 16, 2019
PubMed

Insights

Retesting borderline results for Quantiferon (interferon-gamma release assay) in children showed high variability. Most borderline results became negative upon retesting, suggesting potential false positives in initial tuberculosis screening.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Tuberculosis Diagnostics

Background:

  • Quantiferon testing is used for tuberculosis screening.
  • Borderline results require careful interpretation due to potential variability.

Purpose of the Study:

  • To assess the reproducibility of borderline Quantiferon results in children.
  • To determine the rate of false positives in initial borderline Quantiferon tests.

Main Methods:

  • Systematic retesting of children with borderline-positive Quantiferon results (0.35-0.99 IU/mL) between 2015-2019.
  • Analysis of 647 tests, identifying 27 positive results and 10 borderline-positive results.

Main Results:

  • 10 of 27 (37%) positive Quantiferon tests were initially borderline.
  • 90% (9 of 10) of these borderline results became negative upon retesting.
  • Children under 5 years old with borderline results consistently tested negative on tuberculin skin tests.

Conclusions:

  • High test variability exists for borderline Quantiferon results in children.
  • A significant proportion of borderline Quantiferon results may represent false positives.
  • Further investigation is warranted for borderline Quantiferon results, especially in young children.

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