QuantiFERON to diagnose infection by Mycobacterium tuberculosis: Performance in infants and older children - 28/09/13
Summary |
Objectives |
QuantiFERON value to diagnose tuberculosis (TB) in young children remains to be clarified. To this aim QF-TB-IT performance was evaluated in a large series of immunocompetent children that were stratified according to age and clinical conditions.
Methods |
QF-TB-IT reactivity was analyzed in 226 immunocompetent children (0–15 years old): 31 were uninfected despite TB contact; 51 presented TB disease; 39 had Latent TB (LTBI) and 105 had TB disease suspected but an alternative diagnosis (TB excluded).
Results |
QF-TB-IT specificity was 100% in TB excluded. In TB disease, low sensitivity of QF-TB-IT in infants (40%) increased with aging (77% in 1–<5 years and 82% in 5–<15 years old subgroups). In LTBI, agreement between TST and QF-TB-IT was 0% in infants, 40% in 1–<5 years and 57% in children >5 years old. Finally, the incidence of indeterminate results was high (24%) in children <5 years old with TB excluded, especially with non-TB pneumonitis (61%), but was low (0–6%) regardless of age group in TB disease, LTBI and uninfected contact cases.
Conclusions |
In our low burden country, i) QF-TB-IT specificity was 100%, ii) QF-TB-IT sensitivity was low in infants but commensurable to adult values in older children, and iii) indeterminate results mostly relied on ongoing infections unrelated to TB.
Le texte complet de cet article est disponible en PDF.Keywords : Cytokines, Tuberculosis, Interferon-gamma release assay, Infants
Plan
| ☆ | This work was partly supported by Assistance Publique-Hôpitaux de Paris. There was no grant to anyone for this study. The authors declare that they have no conflict of interest in publishing this article. Adeline Blandinières and Nadège Gourgouillon performed the retrospective analysis of QuantiFERON data. Agathe de Lauzanne and Hélène See took care of the patients and collected clinical data. Valérie Guérin-El Khourouj and Béatrice Pédron performed and validated immunological investigation. Albert Faye and Ghislaine Sterkers designed the study (clinical part Albert Faye and immunological part Ghislaine Sterkers) and wrote the manuscript. Ghislaine Sterkers wrote the first draft of the manuscript. The manuscript has been corrected for language by www.proof-reading-service.com/. Each author listed on the manuscript has seen and approved the submission of this version of the manuscript and takes full responsibility for the manuscript. |
Vol 67 - N° 5
P. 391-398 - novembre 2013 Retour au numéro
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