Rapid diagnosis of Mycobacterium tuberculosis infection in children using interferon-gamma release assays (IGRAs).

Allergy and Asthma Proceedings
Shahla RiaziJoseph A Bellanti

Abstract

Diagnosis of tuberculosis (TB) in children by the tuberculin skin test (TST) poses a diagnostic challenge for physicians due to its low specificity and cross-reactivity with nontuberculous mycobacteria and bacille Calmette-Guerin (BCG). Although interferon-gamma release assays (IGRAs) have been shown as novel TST alternatives for diagnosis of latent TB infection (LTBI) in adults, their effectiveness is less clear in children. The present study examined QuantiFERON-TB Gold (QFT-G) responses and IFN-gamma production capacity of TST-positive children, younger children ≤5 years. A total of 517 children of whom 434 were TST positive ranging in age from 1 month to 18 years were evaluated by the QFT-G. Of the 517 children, 434 (84%) were TST positive, 25 (5.8%) of whom were found to be QFT-G positive and 25 (5.4%) with an indeterminate response. Of the 517 children, 355 (68.7%) were previously BCG immunized and 310/355 (87.3%) were TST positive including 18/27 (66.7%) QFT-positive children. Adequate IFN-gamma production by purified TB peptides or mitogen was observed in 92.8% of children, 29.6% of whom were <5 years. This study shows that the QFT-G assay is useful for diagnosis of LTBI. The finding of 5.8% positive QFT-G in 434 TST-po...Continue Reading

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Citations

Jan 27, 2015·American Journal of Respiratory and Critical Care Medicine·Anna M MandalakasAnneke C Hesseling
May 21, 2016·Journal of the Pediatric Infectious Diseases Society·Jennifer A GrinsdaleJulie M Higashi
Oct 7, 2015·PloS One·Michela SaliPiero Valentini
Nov 16, 2017·The Pediatric Infectious Disease Journal·Anna M MandalakasH Lester Kirchner

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