Enzyme-Linked Immunospot Assay Responses to Early Secretory Antigenic Target 6, Culture Filtrate Protein 10, and Purified Protein Derivative among Children with Tuberculosis: Implications for Diagnosis and Monitoring of Therapy

Nicol, Mark P.; Pienaar, David; Wood, K. J.; Eley, Brian; Wilkinson, Robert J.; Henderson, Harold; Smith, Le'Kneitah P.; Beatty, David M.

doi:10.1086/429245

Cited by 108 publications

(87 citation statements)

References 15 publications

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“…In some cases, the initially negative T SPOT TB results become positive in the process of monitoring, which supports the above hypothesis [15][16][17].…”

Section: Diagnostic Value Of T Spot Tb In Infant To 5-year Old Childrsupporting

confidence: 78%

Diagnostic Value of T SPOT TB in Infant to 5-Year Old Children with Primary Forms of Tuberculosis

Velizarova¹

2014

UCMS

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: IGRA (interferon gamma release assay) testing has marked a new start in the diagnosis of tuberculosis. There is still, however, discrepant evidence in terms of its effectiveness in the early childhood. The purpose of this study was to compare the effectiveness of the new T SPOT TB (ELISPOT TB test) and the TST (tuberculin skin test) in infant children with active tuberculosis. Fifty one (51) children, who were treated at the University Children's Clinic for Pulmonary Diseases in 2009 were studied. The average age of the children was 2.15 ± 1.39 years. Upon examination with the TST, only 2 children reacted negatively, 45.1% were with size of the infiltrate 6 mm to 14 mm at the 72nd h and 51.0% were with size of the infiltrate larger than 15 mm. Upon examination with the T SPOT TB, 69.6% of the children gave positive results, which was significantly less than the 96.1% positive results, obtained with the TST, and in consistency with the study results of other authors. By using both tests, the high rate of 76.7% of positive results was achieved. The concordance between TST and T SPOT TB was 76.4%. This gives us reason to believe that despite the difficulty of diagnosing tuberculosis in infancy, the use of both tests increases our diagnostic capabilities.

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“…In some cases, the initially negative T SPOT TB results become positive in the process of monitoring, which supports the above hypothesis [15][16][17].…”

Section: Diagnostic Value Of T Spot Tb In Infant To 5-year Old Childrsupporting

confidence: 78%

Diagnostic Value of T SPOT TB in Infant to 5-Year Old Children with Primary Forms of Tuberculosis

Velizarova¹

2014

UCMS

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“…LIEBESCHUETZ et al [19] reported a sensitivity of 83% for T-SPOT.TB in African children. NICOL et al [20] described T-SPOT.TB positive results in 70% of children with clinical TB. False negative results of both tests in active TB have been described previously [6,24,25].…”

Section: Discussionmentioning

confidence: 99%

Diagnosing TB infection in children: analysis of discordances usingin vitrotests and the tuberculin skin test

Altet-Gómez¹,

Souza-Galvão²,

Latorre³

et al. 2010

Eur Respir J

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The aim of the present study was to compare the performance of the interferon (IFN)-c tests (QuantiFERON1-TB Gold In-Tube (QFT-G-IT) and T-SPOT1.TB) with the tuberculin skin test (TST) in diagnosing tuberculosis (TB) infection in children, and to analyse discordant results.This was a prospective study including 98 children from contact-tracing studies and 68 children with TST indurations o5 mm recruited during public health screenings.Positive IFN-c tests results were associated with risk of exposure (p,0.0001). T-SPOT.TB was positive in 11 (78.6%) out of 14 cases with active TB and QFT-G-IT in nine (64.3%) out of 14 cases. Sensitised T-cells against Mycobacterium avium were detected in six out of 12 children not vaccinated with bacille Calmette-Guérin (BCG), a TST induration 5-9 mm in diameter and both IFN-c tests negative. In concordant IFN-c tests results, a positive correlation was found (p50.0001) between the number of responding cells and the amount of IFN-c released. However, in discordant IFN-c tests results this correlation was negative (p50.371): an increase in the number of spot-forming cells correlated with a decrease in the amount of IFN-c released.The use of IFN-c tests is helpful for the diagnosis of TB infection, avoiding cross-reactions with BCG immunisation and nontuberculous mycobacterial infections. The analysis of highly discordant results requires further investigation to elucidate possible clinical implications.KEYWORDS: Agreement, children, interferon-c release assays, nontuberculous mycobacterial sensitins, tuberculin skin test, tuberculosis I n 2007, the estimated global incidence of tuberculosis (TB) cases was 9.27 million. Approximately 11% of these cases were children. In the developed world, the estimated proportion of children with TB is around 3-6%, but in developing countries this percentage can reach 15-20%, with an approximate mortality of 30% [1]. Latent TB infection (LTBI) treatment is an essential strategy to eliminate TB [2], although in order to achieve any epidemiological impact, this strategy must target groups with a high risk of infection and development of the disease if they become infected. Children merit special consideration, as they can develop the disease very quickly after primary infection, with the most severe forms prevailing in younger children [3].The advantages of techniques based on the detection of interferon (IFN)-c secreted by effector T-cells stimulated with specific Mycobacterium tuberculosis antigens to diagnose LTBI over the tuberculin skin test (TST) are the lack of cross-reactivity with vaccinal Mycobacterium bovis bacille Calmette-Guérin (BCG) strains and nontuberculous mycobacteria (NTM), and the absence of booster effect [4,5]. These antigens are the early secretory antigenic target (ESAT)-6 and culture filtrate protein (CFP)-10 encoded in region of difference (RD)1, and TB7.7 encoded in RD11, which are absent in all BCG strains and in the majority of NTM. Two commercial in vitro assays based on this technology are currently availab...

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“…constitue le gold standard dans le diagnostic de la tuberculose pulmonaire et ou pleurale chez l'adulte [25].…”

Section: Aspects Chirurgicaux Des Complications Des Tuberculosesunclassified

Surgical aspects of pulmonary and pleural tuberculosis in children

2015

JFVP

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Enzyme-Linked Immunospot Assay Responses to Early Secretory Antigenic Target 6, Culture Filtrate Protein 10, and Purified Protein Derivative among Children with Tuberculosis: Implications for Diagnosis and Monitoring of Therapy

Abstract: Tuberculosis-specific ELISPOT testing is a promising tool that should be evaluated as a potential diagnostic test for childhood tuberculosis. We caution against the use of an early decrease in response as a marker of successful antituberculous chemotherapy.

Cited by 108 publications

References 15 publications

Diagnostic Value of T SPOT TB in Infant to 5-Year Old Children with Primary Forms of Tuberculosis

Diagnostic Value of T SPOT TB in Infant to 5-Year Old Children with Primary Forms of Tuberculosis

Diagnosing TB infection in children: analysis of discordances usingin vitrotests and the tuberculin skin test

Surgical aspects of pulmonary and pleural tuberculosis in children

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