Interferon-Gamma Release Assay Improves the Diagnosis of Tuberculosis in Children

被引:105
作者
Bianchi, Leila [1 ]
Galli, Luisa [1 ]
Moriondo, Maria [1 ]
Veneruso, Giuseppina [1 ]
Becciolini, Laura [1 ]
Azzari, Chiara [1 ]
Chiappini, Elena [1 ]
de Martino, Maurizio [1 ]
机构
[1] Anna Meyer Univ, Childrens Hosp, Univ Florence, Dept Pediat, I-50139 Florence, Italy
关键词
children; diagnosis; interferon-gamma release assay; tuberculosis; tuberculin skin test; SKIN-TEST; MYCOBACTERIUM-TUBERCULOSIS; INFECTION; METAANALYSIS; GUIDELINES; TESTS; RISK; GOLD;
D O I
10.1097/INF.0b013e31819abf6b
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Interferon-gamma release assays (IGRAs) have been recently developed for the diagnosis of tuberculosis (TB) infection. The aim of the present study was to evaluate the performance of in enzyme-linked immunosorbent assay (ELISA)-based IGRA for detecting TB in children. Methods: A prospective study in 336 children at risk for TB infection was carried out. All children were tested with tuberculin skin test (TST) and a commercial ELISA-based IGRA [QuantiFERON-TB Gold In-Tube (Cellestis)] Results: TST were positive in 58 of 336 (17.3%) and IGRA in 60 of 336 (17.9%) children. Two (0.6%) IGRA results were indeterminate. The overall agreement between the 2 tests was intermediate (86.2%, kappa = 0.533). IGRA was positive in 15 of 16 (93,8%) children with active pulmonary TB. The discordant pattern IGRA-/TST+ was significantly associated with Bacille Calmette-Guerin (BCG) vaccination. Among IGRA+ children (excluding cases of TB disease), TST-were significantly younger than TST+ children. Conclusions: The good agreement between positive IGRA and active TB disease suggests a good sensitivity of IGRA. Discrepancies between IGRA and TST can be a result of higher specificity of IGRA that is not influenced by previous BCG vaccination. IGRA may be more sensitive in children younger than 48 months.
引用
收藏
页码:510 / 514
页数:5
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