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Temporal dynamics of interferon gamma responses in children evaluated for tuberculosis.

Herrmann JL, Belloy M, Porcher R, Simonney N, Aboutaam R, Lebourgeois M, Gaudelus J, De Losangeles L, Chadelat K, Scheinmann P, Beydon N, Fauroux B, Bingen M, Terki M, Barraud D, Cruaud P, Offredo C, Ferroni A, Berche P, Moissenet D, Vuthien H, Doit C, Bingen E, Lagrange PH - PLoS ONE (2009)

Bottom Line: LTBI and active TB children undergoing therapy produced significant higher IFNgamma values after 10 days of treatment (p = 0.035).In addition, IFNgamma values were significantly lower at the end of treatment compared to IFNgamma values at day 0, although the number of positive patients was not significantly different between day 0 and end of treatment.In addition, a decline in IFNgamma values during treatment makes it possible for clinicians to monitor the effect of preventive or curative therapy.

View Article: PubMed Central - PubMed

Affiliation: Service de Microbiologie, Hôpital St Louis et Equipe d'Accueil (EA3510), Assistance Publique Hôpitaux de Paris et UFR Denis Diderot, Paris, France. jean-louis.herrmann@rpc.aphp.fr

ABSTRACT

Background: Development of T-cells based-Interferon gamma (IFNgamma) assays has offered new possibilities for the diagnosis of latent tuberculosis infection (LTBI) and active disease in adults. Few studies have been performed in children, none in France. With reference to the published data on childhood TB epidemiology in the Paris and Ile de France Region, we considered it important to evaluate the performance of IGRA (QuantiFERON TB Gold In Tube(R), QF-TB-IT) in the diagnosis and the follow-up through treatment of LTBI and active TB in a cohort of French children.

Methodology/principal findings: 131 children were recruited during a prospective and multicentre study (October 2005 and May 2007; Ethical Committee St Louis Hospital, Paris, study number 2005/32). Children were sampled at day 0, 10, 30, 60 (except Healthy Contacts, HC) and 90 for LTBI and HC, and a further day 120, and day 180 for active TB children. Median age was 7.4 years, with 91% of the children BCG vaccinated. LTBI and active TB children undergoing therapy produced significant higher IFNgamma values after 10 days of treatment (p = 0.035). In addition, IFNgamma values were significantly lower at the end of treatment compared to IFNgamma values at day 0, although the number of positive patients was not significantly different between day 0 and end of treatment.

Conclusions/ significance: By following quantitative IFNgamma values in each enrolled child with LTBI or active TB and receiving treatment, we were able to detect an increase in the IFNgamma response at day 10 of treatment which might allow the confirmation of a diagnosis. In addition, a decline in IFNgamma values during treatment makes it possible for clinicians to monitor the effect of preventive or curative therapy.

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ROC curve of QF-TB-IT to predict TB infection in LTBI with known family contact and active TB children.
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pone-0004130-g002: ROC curve of QF-TB-IT to predict TB infection in LTBI with known family contact and active TB children.

Mentions: We evaluated the performance of QF-TB-IT as a marker of TB infection, defined as LTBI children with a known family TB contact (32 children) and active TB children (32 children) versus healthy contacts (12 children) or children with LTBI and no TB contact (22 children). The area under the ROC curve was 0.692 (figure 2). When using the supplier defined positivity threshold at 0.35, this resulted in a sensitivity of 69% (95%CI 56% to 80%) and a specificity of 61% (42% to 78%).


Temporal dynamics of interferon gamma responses in children evaluated for tuberculosis.

Herrmann JL, Belloy M, Porcher R, Simonney N, Aboutaam R, Lebourgeois M, Gaudelus J, De Losangeles L, Chadelat K, Scheinmann P, Beydon N, Fauroux B, Bingen M, Terki M, Barraud D, Cruaud P, Offredo C, Ferroni A, Berche P, Moissenet D, Vuthien H, Doit C, Bingen E, Lagrange PH - PLoS ONE (2009)

ROC curve of QF-TB-IT to predict TB infection in LTBI with known family contact and active TB children.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2607538&req=5

pone-0004130-g002: ROC curve of QF-TB-IT to predict TB infection in LTBI with known family contact and active TB children.
Mentions: We evaluated the performance of QF-TB-IT as a marker of TB infection, defined as LTBI children with a known family TB contact (32 children) and active TB children (32 children) versus healthy contacts (12 children) or children with LTBI and no TB contact (22 children). The area under the ROC curve was 0.692 (figure 2). When using the supplier defined positivity threshold at 0.35, this resulted in a sensitivity of 69% (95%CI 56% to 80%) and a specificity of 61% (42% to 78%).

Bottom Line: LTBI and active TB children undergoing therapy produced significant higher IFNgamma values after 10 days of treatment (p = 0.035).In addition, IFNgamma values were significantly lower at the end of treatment compared to IFNgamma values at day 0, although the number of positive patients was not significantly different between day 0 and end of treatment.In addition, a decline in IFNgamma values during treatment makes it possible for clinicians to monitor the effect of preventive or curative therapy.

View Article: PubMed Central - PubMed

Affiliation: Service de Microbiologie, Hôpital St Louis et Equipe d'Accueil (EA3510), Assistance Publique Hôpitaux de Paris et UFR Denis Diderot, Paris, France. jean-louis.herrmann@rpc.aphp.fr

ABSTRACT

Background: Development of T-cells based-Interferon gamma (IFNgamma) assays has offered new possibilities for the diagnosis of latent tuberculosis infection (LTBI) and active disease in adults. Few studies have been performed in children, none in France. With reference to the published data on childhood TB epidemiology in the Paris and Ile de France Region, we considered it important to evaluate the performance of IGRA (QuantiFERON TB Gold In Tube(R), QF-TB-IT) in the diagnosis and the follow-up through treatment of LTBI and active TB in a cohort of French children.

Methodology/principal findings: 131 children were recruited during a prospective and multicentre study (October 2005 and May 2007; Ethical Committee St Louis Hospital, Paris, study number 2005/32). Children were sampled at day 0, 10, 30, 60 (except Healthy Contacts, HC) and 90 for LTBI and HC, and a further day 120, and day 180 for active TB children. Median age was 7.4 years, with 91% of the children BCG vaccinated. LTBI and active TB children undergoing therapy produced significant higher IFNgamma values after 10 days of treatment (p = 0.035). In addition, IFNgamma values were significantly lower at the end of treatment compared to IFNgamma values at day 0, although the number of positive patients was not significantly different between day 0 and end of treatment.

Conclusions/ significance: By following quantitative IFNgamma values in each enrolled child with LTBI or active TB and receiving treatment, we were able to detect an increase in the IFNgamma response at day 10 of treatment which might allow the confirmation of a diagnosis. In addition, a decline in IFNgamma values during treatment makes it possible for clinicians to monitor the effect of preventive or curative therapy.

Show MeSH
Related in: MedlinePlus