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Risk Factors for False-Negative Interferon-γ Release Assay Results in Culture-Confirmed Childhood TB

Mao-Shui Wang1,2, Xin-Jie Liu2

  • 1Department of Lab Medicine, Shandong Provincial Chest Hospital, Jinan, China.

The American Journal of Tropical Medicine and Hygiene
|November 2, 2019
PubMed

Insights

False-negative interferon-γ release assay (IGRA) results in childhood tuberculosis (TB) are linked to younger age, being overweight, and hypoproteinemia. These factors may delay diagnosis and treatment for pediatric TB patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Diagnostics
  • Tuberculosis Research

Background:

  • Interferon-γ release assays (IGRAs) are crucial for diagnosing tuberculosis (TB).
  • False-negative IGRA results in children can lead to delayed TB diagnosis and treatment.
  • Risk factors for false-negative IGRA results in pediatric TB are not well understood.

Purpose of the Study:

  • To identify risk factors associated with false-negative T-SPOT.TB results in children with confirmed TB.
  • To improve the diagnostic accuracy of IGRA in pediatric TB cases.

Main Methods:

  • Retrospective study of 156 culture-confirmed childhood TB patients who underwent T-SPOT.TB testing.
  • Data collected via questionnaires included demographics and clinicopathological variables.
  • Univariate and multivariate logistic regression analyses were used to identify risk factors.

Main Results:

  • The T-SPOT.TB test had a positive rate of 85.9% in childhood TB patients.
  • Multivariate analysis identified younger age (≤ 9 years), overweight (z-score > 0.37), and hypoproteinemia (total protein ≤ 68.4 g/L) as significant risk factors for false-negative results.
  • These factors were associated with increased odds of false-negative IGRA results.

Conclusions:

  • Younger age, being overweight, and hypoproteinemia are associated with false-negative T-SPOT.TB results in children.
  • Healthcare professionals should consider these risk factors when interpreting IGRA results in suspected pediatric TB cases.
  • This finding can help mitigate diagnostic delays in children with TB.

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