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Performance of commercial blood tests for the diagnosis of latent tuberculosis infection in children and adolescents

Performance of commercial blood tests for the diagnosis of latent tuberculosis infection in children and adolescents
Performance of commercial blood tests for the diagnosis of latent tuberculosis infection in children and adolescents
BACKGROUND:
The accurate diagnosis of latent tuberculosis infection reduces the risk of progression to severe disseminated disease. However, in young children, a major limitation of the standard tuberculin skin test is that false-negative results cannot be detected. The new interferon-gamma release assays QuantiFERON-TB Gold (Cellestis Carnegie Victoria, Australia), QuantiFERON-TB In-Tube (Cellestis), and T-SPOT.TB (Oxford Immunotec, Abingdon, United Kingdom) show promise of greater accuracy, but they may also be affected by impaired cellular immunity, resulting in indeterminate results (ie, insufficient response in positive-control wells).

OBJECTIVE:
To evaluate the impact of age on the performance of interferon-gamma release assays when used in a routine hospital setting among children tested for suspected active or latent TB infection.

METHODS:
We retrospectively studied 496 children 0 to 19 years of age who had been tested with the tuberculin skin test and at least 1 interferon-gamma release assay: 181 with QuantiFERON-TB Gold and 315 with QuantiFERON-TB In-Tube. In 154 of the children, paired interferon-gamma release assay testing was available: 87 with QuantiFERON-TB Gold/T-SPOT.TB and 67 with QuantiFERON-TB In-Tube/T-SPOT.TB.

RESULTS:
Compared with T-SPOT.TB, the rates of indeterminate results were significantly higher for both QuantiFERON-TB Gold and QuantiFERON-TB In-Tube. QuantiFERON-TB Gold and QuantiFERON-TB In-Tube also gave indeterminate results more frequently in children <4 years of age than in those >/=4 years of age. Indeterminate results were associated with younger age for both QuantiFERON-TB Gold and QuantiFERON-TB In-Tube but not for T-SPOT.TB. Considering age as a binary variable (<4 and >/=4 years of age), a significantly higher concentration of phytohaemagglutinin-produced interferon-gamma was observed in older children with both QuantiFERON-TB Gold and QuantiFERON-TB In-Tube.

CONCLUSION:
Different blood tests for the diagnosis of latent tuberculosis infection in children seem to perform differently, because both QuantiFERON-TB tests were more likely than T-SPOT.TB to give indeterminate results in children <4 years of age.
0031-4005
e419-e424
Bergamini, Barbara Maria
534ef375-cc9c-4ec7-bcb2-a4db967a1620
Losi, Monica
6f2acb9f-04c8-45fc-9921-7b0a0f439129
Vaienti, Francesca
0db40d22-57c0-422d-9bd6-6bc74c47e794
D'Amico, Roberto
6bf14206-022d-4e7e-b3e5-080912dc6e42
Meccugni, Barbara
14347389-ddc4-4cd4-aeef-aeaea1b1cbc1
Meacci, Marisa
d3d2a4d9-b796-4f11-9633-cfd398e2ab17
De Giovanni, Donatella
31fe34f8-8fbf-4ff2-8beb-3f666306b964
Rumpianesi, Fabio
a62c228d-61d7-4be3-85ba-abd445e595f9
Fabbri, Leonardo M.
0f4844a3-b97f-4c2d-9414-bd8d5bd383b7
Balli, Fiorella
e77bb17e-9a3b-454f-9084-fac0283df1ae
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Bergamini, Barbara Maria
534ef375-cc9c-4ec7-bcb2-a4db967a1620
Losi, Monica
6f2acb9f-04c8-45fc-9921-7b0a0f439129
Vaienti, Francesca
0db40d22-57c0-422d-9bd6-6bc74c47e794
D'Amico, Roberto
6bf14206-022d-4e7e-b3e5-080912dc6e42
Meccugni, Barbara
14347389-ddc4-4cd4-aeef-aeaea1b1cbc1
Meacci, Marisa
d3d2a4d9-b796-4f11-9633-cfd398e2ab17
De Giovanni, Donatella
31fe34f8-8fbf-4ff2-8beb-3f666306b964
Rumpianesi, Fabio
a62c228d-61d7-4be3-85ba-abd445e595f9
Fabbri, Leonardo M.
0f4844a3-b97f-4c2d-9414-bd8d5bd383b7
Balli, Fiorella
e77bb17e-9a3b-454f-9084-fac0283df1ae
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26

Bergamini, Barbara Maria, Losi, Monica, Vaienti, Francesca, D'Amico, Roberto, Meccugni, Barbara, Meacci, Marisa, De Giovanni, Donatella, Rumpianesi, Fabio, Fabbri, Leonardo M., Balli, Fiorella and Richeldi, Luca (2009) Performance of commercial blood tests for the diagnosis of latent tuberculosis infection in children and adolescents. Pediatrics, 123 (3), e419-e424. (doi:10.1542/peds.2008-1722). (PMID:19254978)

Record type: Article

Abstract

BACKGROUND:
The accurate diagnosis of latent tuberculosis infection reduces the risk of progression to severe disseminated disease. However, in young children, a major limitation of the standard tuberculin skin test is that false-negative results cannot be detected. The new interferon-gamma release assays QuantiFERON-TB Gold (Cellestis Carnegie Victoria, Australia), QuantiFERON-TB In-Tube (Cellestis), and T-SPOT.TB (Oxford Immunotec, Abingdon, United Kingdom) show promise of greater accuracy, but they may also be affected by impaired cellular immunity, resulting in indeterminate results (ie, insufficient response in positive-control wells).

OBJECTIVE:
To evaluate the impact of age on the performance of interferon-gamma release assays when used in a routine hospital setting among children tested for suspected active or latent TB infection.

METHODS:
We retrospectively studied 496 children 0 to 19 years of age who had been tested with the tuberculin skin test and at least 1 interferon-gamma release assay: 181 with QuantiFERON-TB Gold and 315 with QuantiFERON-TB In-Tube. In 154 of the children, paired interferon-gamma release assay testing was available: 87 with QuantiFERON-TB Gold/T-SPOT.TB and 67 with QuantiFERON-TB In-Tube/T-SPOT.TB.

RESULTS:
Compared with T-SPOT.TB, the rates of indeterminate results were significantly higher for both QuantiFERON-TB Gold and QuantiFERON-TB In-Tube. QuantiFERON-TB Gold and QuantiFERON-TB In-Tube also gave indeterminate results more frequently in children <4 years of age than in those >/=4 years of age. Indeterminate results were associated with younger age for both QuantiFERON-TB Gold and QuantiFERON-TB In-Tube but not for T-SPOT.TB. Considering age as a binary variable (<4 and >/=4 years of age), a significantly higher concentration of phytohaemagglutinin-produced interferon-gamma was observed in older children with both QuantiFERON-TB Gold and QuantiFERON-TB In-Tube.

CONCLUSION:
Different blood tests for the diagnosis of latent tuberculosis infection in children seem to perform differently, because both QuantiFERON-TB tests were more likely than T-SPOT.TB to give indeterminate results in children <4 years of age.

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More information

Published date: March 2009
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 369022
URI: https://eprints.soton.ac.uk/id/eprint/369022
ISSN: 0031-4005
PURE UUID: 79917619-e648-4d83-803f-5afa4621c6de

Catalogue record

Date deposited: 23 Sep 2014 12:58
Last modified: 15 Jul 2019 21:44

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Contributors

Author: Barbara Maria Bergamini
Author: Monica Losi
Author: Francesca Vaienti
Author: Roberto D'Amico
Author: Barbara Meccugni
Author: Marisa Meacci
Author: Donatella De Giovanni
Author: Fabio Rumpianesi
Author: Leonardo M. Fabbri
Author: Fiorella Balli
Author: Luca Richeldi

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