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Accuracy of QuantiFERON-TB Gold Test for Tuberculosis Diagnosis in Children.

Sali M, Buonsenso D, Goletti D, D'Alfonso P, Zumbo A, Fadda G, Sanguinetti M, Delogu G, Valentini P - PLoS ONE (2015)

Bottom Line: The overall specificity for active TB was 93.6%.Our results indicate that the children's response to QFT-IT associates to active TB and risk factors for LTBI.Moreover, we show that mitogen response is also found in children of 1 year of age, providing support for QFT-IT use also in young children.

View Article: PubMed Central - PubMed

Affiliation: Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy.

ABSTRACT

Objectives: To evaluate the accuracy of the QuantiFERON-TB Gold assay (QFT-IT) in children with suspected active or latent TB infection (LTBI).

Methods: A retrospective study was conducted on 621 children (0-14 years old) evaluated for TB infection or disease. Following clinical assessment, children were tested with the QFT-IT assay.

Results: Among the 140 active TB suspects, we identified 19 cases of active disease. The overall sensitivity for active TB was 87.5%, ranging from 62.5% in children 25-36 months old to 100% in children older than 49 months. The overall specificity for active TB was 93.6%. Among the 481 children tested for LTBI screening, 38 scored positive and all but 2 had at least one risk factor for TB infection. Among the 26 children with indeterminate results, bacterial, viral or fungal pneumonia were later diagnosed in 11 (42.3%) cases and non-TB related extra-pulmonary infections in 12 (46.1%).

Conclusions: Our results indicate that the children's response to QFT-IT associates to active TB and risk factors for LTBI. Moreover, we show that mitogen response is also found in children of 1 year of age, providing support for QFT-IT use also in young children.

No MeSH data available.


Related in: MedlinePlus

Quantitative response to QuantiFeron TB Gold-In Tube in relationship to age.IFN-γ levels in response to stimulation with M. tuberculosis antigens (A) and mitogen (B); individual QFT-IT results are plotted according to their final diagnosis and age. The cut-off value for a positive QFT-IT is represented by the dotted line at 0.35 IU/ml.
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pone.0138952.g002: Quantitative response to QuantiFeron TB Gold-In Tube in relationship to age.IFN-γ levels in response to stimulation with M. tuberculosis antigens (A) and mitogen (B); individual QFT-IT results are plotted according to their final diagnosis and age. The cut-off value for a positive QFT-IT is represented by the dotted line at 0.35 IU/ml.

Mentions: To investigate the relationship between age and ability to respond to the TB-specific antigens used in QFT-IT, we analyzed the IFN-γ response of all children showing a positive result (Table 3, Fig 2A). The proportion of positivity to QFT-IT ranged from 7.8% for the 25–36 months of age group to 10.9% for the 37–48 months of age group (Table 3), although the real significance of this value remains questionable given the non-homogeneity among the different age groups. Only 4 out of 52 children aged ≤ 12 months scored positive by QFT-IT; three of these children were diagnosed as active TB, while the fourth was a healthy child born in a TB-endemic country, diagnosed with LTBI. To note: one eight-month-old child with severe meningeal and cerebral TB (who did not survive) was scored QFT-IT indeterminate. In the 13–24 months age group, 11 out of 117 children scored positive and a final diagnosis of active TB was made for 7 of them. The remaining 4 children were diagnosed as LTBI: one child was a family contact of a smear-positive active TB adult, two children were born in TB-endemic countries, and for one child it was not possible to identify the risk factor for TB infection. In the 25–36 months of age group, six children scored QFT-IT positive and 5 of them were diagnosed as active TB. In the other three age groups (> 36 months), of the 38 children who scored positive by the QFT-IT, only two were diagnosed with active TB. Taken together, these results indicate that among the 21 QFT-IT -positive children ≤ 36 months, 15 were active TB and the remaining six were diagnosed as LTBI with a good correlation with TB risk factors.


Accuracy of QuantiFERON-TB Gold Test for Tuberculosis Diagnosis in Children.

Sali M, Buonsenso D, Goletti D, D'Alfonso P, Zumbo A, Fadda G, Sanguinetti M, Delogu G, Valentini P - PLoS ONE (2015)

Quantitative response to QuantiFeron TB Gold-In Tube in relationship to age.IFN-γ levels in response to stimulation with M. tuberculosis antigens (A) and mitogen (B); individual QFT-IT results are plotted according to their final diagnosis and age. The cut-off value for a positive QFT-IT is represented by the dotted line at 0.35 IU/ml.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4595419&req=5

pone.0138952.g002: Quantitative response to QuantiFeron TB Gold-In Tube in relationship to age.IFN-γ levels in response to stimulation with M. tuberculosis antigens (A) and mitogen (B); individual QFT-IT results are plotted according to their final diagnosis and age. The cut-off value for a positive QFT-IT is represented by the dotted line at 0.35 IU/ml.
Mentions: To investigate the relationship between age and ability to respond to the TB-specific antigens used in QFT-IT, we analyzed the IFN-γ response of all children showing a positive result (Table 3, Fig 2A). The proportion of positivity to QFT-IT ranged from 7.8% for the 25–36 months of age group to 10.9% for the 37–48 months of age group (Table 3), although the real significance of this value remains questionable given the non-homogeneity among the different age groups. Only 4 out of 52 children aged ≤ 12 months scored positive by QFT-IT; three of these children were diagnosed as active TB, while the fourth was a healthy child born in a TB-endemic country, diagnosed with LTBI. To note: one eight-month-old child with severe meningeal and cerebral TB (who did not survive) was scored QFT-IT indeterminate. In the 13–24 months age group, 11 out of 117 children scored positive and a final diagnosis of active TB was made for 7 of them. The remaining 4 children were diagnosed as LTBI: one child was a family contact of a smear-positive active TB adult, two children were born in TB-endemic countries, and for one child it was not possible to identify the risk factor for TB infection. In the 25–36 months of age group, six children scored QFT-IT positive and 5 of them were diagnosed as active TB. In the other three age groups (> 36 months), of the 38 children who scored positive by the QFT-IT, only two were diagnosed with active TB. Taken together, these results indicate that among the 21 QFT-IT -positive children ≤ 36 months, 15 were active TB and the remaining six were diagnosed as LTBI with a good correlation with TB risk factors.

Bottom Line: The overall specificity for active TB was 93.6%.Our results indicate that the children's response to QFT-IT associates to active TB and risk factors for LTBI.Moreover, we show that mitogen response is also found in children of 1 year of age, providing support for QFT-IT use also in young children.

View Article: PubMed Central - PubMed

Affiliation: Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy.

ABSTRACT

Objectives: To evaluate the accuracy of the QuantiFERON-TB Gold assay (QFT-IT) in children with suspected active or latent TB infection (LTBI).

Methods: A retrospective study was conducted on 621 children (0-14 years old) evaluated for TB infection or disease. Following clinical assessment, children were tested with the QFT-IT assay.

Results: Among the 140 active TB suspects, we identified 19 cases of active disease. The overall sensitivity for active TB was 87.5%, ranging from 62.5% in children 25-36 months old to 100% in children older than 49 months. The overall specificity for active TB was 93.6%. Among the 481 children tested for LTBI screening, 38 scored positive and all but 2 had at least one risk factor for TB infection. Among the 26 children with indeterminate results, bacterial, viral or fungal pneumonia were later diagnosed in 11 (42.3%) cases and non-TB related extra-pulmonary infections in 12 (46.1%).

Conclusions: Our results indicate that the children's response to QFT-IT associates to active TB and risk factors for LTBI. Moreover, we show that mitogen response is also found in children of 1 year of age, providing support for QFT-IT use also in young children.

No MeSH data available.


Related in: MedlinePlus