BACKGROUND: Interferon-gamma release assays (IGRAs) have high specificity and sensitivity for the diagnosis of tuberculosis (TB) infection. However, their role as a screening tool in children with immunodeficiency disorders is still unclear. In the present study, we performed a contact investigation using serial IGRAs on children with immunodeficiency conditions exposed to a contagious TB patient. METHODS: Children who were exposed to a contagious TB case underwent serial QuantiFERON(®) TB Gold In-Tube (QFT-GIT) and T-SPOT(®).TB (T-SPOT) testing. RESULTS: Eighteen children were tested. At the first testing, only two children (11 %) were positive to T-SPOT. Indeterminate results were more frequent with QFT-GIT (35 %) than with T-SPOT (12 %). In the multivariable analysis, a statistically significant association of lymphocyte count <500 cells/mm(3) (p < 0.00005) and low age (p = 0.03) with indeterminate results for the QFT-GIT test but not for T-SPOT (p = 0.10 and p = 0.88, respectively) was found. At the end of October 2012, 15 of the 18 children were alive and none developed active TB disease. CONCLUSION: T-SPOT provided more determinate results and was less influenced by low age and lymphocytopenia than QFT-GIT in this population of immunodeficient children. These findings suggest that T-SPOT is a more accurate test for the identification of TB infection in young children with lymphocytopenia and should be preferred to QFT-GIT under such specific conditions.
BACKGROUND:Interferon-gamma release assays (IGRAs) have high specificity and sensitivity for the diagnosis of tuberculosis (TB) infection. However, their role as a screening tool in children with immunodeficiency disorders is still unclear. In the present study, we performed a contact investigation using serial IGRAs on children with immunodeficiency conditions exposed to a contagious TB patient. METHODS:Children who were exposed to a contagious TB case underwent serial QuantiFERON(®) TB Gold In-Tube (QFT-GIT) and T-SPOT(®).TB (T-SPOT) testing. RESULTS: Eighteen children were tested. At the first testing, only two children (11 %) were positive to T-SPOT. Indeterminate results were more frequent with QFT-GIT (35 %) than with T-SPOT (12 %). In the multivariable analysis, a statistically significant association of lymphocyte count <500 cells/mm(3) (p < 0.00005) and low age (p = 0.03) with indeterminate results for the QFT-GIT test but not for T-SPOT (p = 0.10 and p = 0.88, respectively) was found. At the end of October 2012, 15 of the 18 children were alive and none developed active TB disease. CONCLUSION: T-SPOT provided more determinate results and was less influenced by low age and lymphocytopenia than QFT-GIT in this population of immunodeficientchildren. These findings suggest that T-SPOT is a more accurate test for the identification of TB infection in young children with lymphocytopenia and should be preferred to QFT-GIT under such specific conditions.
Authors: D C Stefan; A Dippenaar; A K Detjen; H S Schaaf; B J Marais; B Kriel; L Loebenberg; G Walzl; A C Hesseling Journal: Int J Tuberc Lung Dis Date: 2010-06 Impact factor: 2.373
Authors: Tom G Connell; Mary-Ann Davies; Christine Johannisen; Kathryn Wood; Sandy Pienaar; Katalin A Wilkinson; Robert J Wilkinson; Heather J Zar; David Beatty; Mark P Nicol; Nigel Curtis; Brian Eley Journal: BMC Infect Dis Date: 2010-05-27 Impact factor: 3.090
Authors: M Pai; R Joshi; S Dogra; A A Zwerling; D Gajalakshmi; K Goswami; M V R Reddy; A Kalantri; P C Hill; D Menzies; P C Hopewell Journal: Int J Tuberc Lung Dis Date: 2009-01 Impact factor: 2.373
Authors: Noëmi R Meier; Thomas Volken; Marc Geiger; Ulrich Heininger; Marc Tebruegge; Nicole Ritz Journal: Front Pediatr Date: 2019-05-29 Impact factor: 3.418