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Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis.

Li T, Bao L, Diao N, Sun F, Gao Y, Wong KW, Xi X, Liu X, Wang S, Wu J, Hui M, Fan X, Zhang Y, Zhang W, Lu S - Clin. Exp. Med. (2014)

Bottom Line: There was no significant difference of the positive rate of both tests in children <5 years old compared with those ≥5 years old.Glucocorticoids had a significant negative influence on IGRAs if treated for >1 week.Age made no difference on the performance of these tests in children.

View Article: PubMed Central - PubMed

Affiliation: Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.

ABSTRACT
Diagnosis of active tuberculosis (TB) in children remains difficult. This study aimed at evaluating the ability of interferon-gamma release assays (IGRAs) in the detection of active TB in human immunodeficiency virus-negative children vaccinated with Bacille Calmette-Guérin and investigating the effect of prednisolone treatment on the IGRAs performance. Among the 162 children with suspected TB disease recruited in China, 60 were tested with QuantiFERON-TB Gold In Tube (QFT-GIT) and 102 were tested with T-SPOT.TB. QFT-GIT presented a sensitivity of 83.9 % (95 % CI 66.9-93.4 %) and a specificity of 88.5 % (95 % CI 70.2-96.8 %), while T-SPOT.TB had a sensitivity of 75.9 % (95 % CI 63.4-85.2 %) and a specificity of 94.7 % (95 % CI 81.8-99.5 %). The positive predictive value was high in both assays, 92.9 % for QFT-GIT and 95.7 % for T-SPOT.TB. In total of these two kinds of IGRAs, false negative rate was significantly higher in children receiving systemic prednisolone (1 mg/kg/day) therapy for >1 week (two tested with T-SPOT.TB and five tested with QFT-GIT) than in those with ≤1 week of prednisolone therapy and without prednisolone therapy (57.1 vs. 18.3 %, p = 0.035). There was no significant difference of the positive rate of both tests in children <5 years old compared with those ≥5 years old. Both types of IGRAs showed good diagnostic values in detecting childhood TB before microbiological evidence was available. Glucocorticoids had a significant negative influence on IGRAs if treated for >1 week. Age made no difference on the performance of these tests in children.

No MeSH data available.


Related in: MedlinePlus

Effects of prednisolone treatment on T-SPOT.TB and QFT-GIT results of children with ATB (w week)
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Fig2: Effects of prednisolone treatment on T-SPOT.TB and QFT-GIT results of children with ATB (w week)

Mentions: Six children tested with T-SPOT.TB and 12 children tested with QFT-GIT had received treatment with prednisolone in our study. Prednisolone was prescribed to control the inflammatory reaction in children with tuberculous pleuritis or tuberculous meningitis. In comparison with the numbers of SFCs in panel A and B in T-SPOT.TB or the concentration of IFN-γ in TB antigen tube in QFT-GIT, a tendency of decrease in IFN-γ release after prednisolone therapy was both observed in T-SPOT.TB (mean SFCs for panel A: 28.8 vs. 58.2, mean SFCs for panel B: 34 vs. 68.9) and QFT-GIT (mean concentration: 3.98 IU/ml vs. 5.35 IU/ml), but the difference was not significant (p > 0.05).According to the duration of prednisolone therapy prior to IGRAs, we regrouped the cases into children with prednisolone (1 mg/kg/day) for >1 week and with prednisolone (1 mg/kg/day) for ≤1 week or without prednisolone treatment. Two children tested with T-SPOT.TB and five children tested with QFT-GIT had been treated with prednisolone for more than 1 week. The false negative rate of T-SPOT.TB and QFT-GIT was 57.1 % (one tested with T-SPOT.TB and three with QFT-GIT) in children with >1 week of prednisolone therapy higher than 18.3 % (13 tested with T-SPOT.TB and two with QFT-GIT) of others with shorter/no therapy (p = 0.035) (Fig. 2).Fig. 2


Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis.

Li T, Bao L, Diao N, Sun F, Gao Y, Wong KW, Xi X, Liu X, Wang S, Wu J, Hui M, Fan X, Zhang Y, Zhang W, Lu S - Clin. Exp. Med. (2014)

Effects of prednisolone treatment on T-SPOT.TB and QFT-GIT results of children with ATB (w week)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4522271&req=5

Fig2: Effects of prednisolone treatment on T-SPOT.TB and QFT-GIT results of children with ATB (w week)
Mentions: Six children tested with T-SPOT.TB and 12 children tested with QFT-GIT had received treatment with prednisolone in our study. Prednisolone was prescribed to control the inflammatory reaction in children with tuberculous pleuritis or tuberculous meningitis. In comparison with the numbers of SFCs in panel A and B in T-SPOT.TB or the concentration of IFN-γ in TB antigen tube in QFT-GIT, a tendency of decrease in IFN-γ release after prednisolone therapy was both observed in T-SPOT.TB (mean SFCs for panel A: 28.8 vs. 58.2, mean SFCs for panel B: 34 vs. 68.9) and QFT-GIT (mean concentration: 3.98 IU/ml vs. 5.35 IU/ml), but the difference was not significant (p > 0.05).According to the duration of prednisolone therapy prior to IGRAs, we regrouped the cases into children with prednisolone (1 mg/kg/day) for >1 week and with prednisolone (1 mg/kg/day) for ≤1 week or without prednisolone treatment. Two children tested with T-SPOT.TB and five children tested with QFT-GIT had been treated with prednisolone for more than 1 week. The false negative rate of T-SPOT.TB and QFT-GIT was 57.1 % (one tested with T-SPOT.TB and three with QFT-GIT) in children with >1 week of prednisolone therapy higher than 18.3 % (13 tested with T-SPOT.TB and two with QFT-GIT) of others with shorter/no therapy (p = 0.035) (Fig. 2).Fig. 2

Bottom Line: There was no significant difference of the positive rate of both tests in children <5 years old compared with those ≥5 years old.Glucocorticoids had a significant negative influence on IGRAs if treated for >1 week.Age made no difference on the performance of these tests in children.

View Article: PubMed Central - PubMed

Affiliation: Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.

ABSTRACT
Diagnosis of active tuberculosis (TB) in children remains difficult. This study aimed at evaluating the ability of interferon-gamma release assays (IGRAs) in the detection of active TB in human immunodeficiency virus-negative children vaccinated with Bacille Calmette-Guérin and investigating the effect of prednisolone treatment on the IGRAs performance. Among the 162 children with suspected TB disease recruited in China, 60 were tested with QuantiFERON-TB Gold In Tube (QFT-GIT) and 102 were tested with T-SPOT.TB. QFT-GIT presented a sensitivity of 83.9 % (95 % CI 66.9-93.4 %) and a specificity of 88.5 % (95 % CI 70.2-96.8 %), while T-SPOT.TB had a sensitivity of 75.9 % (95 % CI 63.4-85.2 %) and a specificity of 94.7 % (95 % CI 81.8-99.5 %). The positive predictive value was high in both assays, 92.9 % for QFT-GIT and 95.7 % for T-SPOT.TB. In total of these two kinds of IGRAs, false negative rate was significantly higher in children receiving systemic prednisolone (1 mg/kg/day) therapy for >1 week (two tested with T-SPOT.TB and five tested with QFT-GIT) than in those with ≤1 week of prednisolone therapy and without prednisolone therapy (57.1 vs. 18.3 %, p = 0.035). There was no significant difference of the positive rate of both tests in children <5 years old compared with those ≥5 years old. Both types of IGRAs showed good diagnostic values in detecting childhood TB before microbiological evidence was available. Glucocorticoids had a significant negative influence on IGRAs if treated for >1 week. Age made no difference on the performance of these tests in children.

No MeSH data available.


Related in: MedlinePlus