QuantiFERON-TB Performs Better in Children, Including Infants, than in Adults with Active Tuberculosis: a Multicenter Study

Lombardi, Giuseppe; Pellegrino, Maria Teresa; Denicolò, Agnese; Corsini, Ilaria; Tadolini, Marina; Bergamini, Barbara Maria; Meacci, Marisa; Garazzino, Silvia; Peracchi, Marta; Lanari, Marcello; Re, Maria Carla; Monte, Paola Dal

doi:10.1128/jcm.01048-19

Cited by 15 publications

(6 citation statements)

References 33 publications

(32 reference statements)

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“…Our data and others indicate that indeterminate results are more common among children than older populations (excluding adults >65 years of age in our study) ( 32 ). Impaired immunity has been independently associated with a higher probability of an indeterminate QFT-GIT ( 33 , 34 ), along with patients with active TB ( 32 ). One study suggested that T-cell based assays, such as QFT, have poor performance in children with immature or impaired immune systems ( 35 ).…”

Section: Discussionsupporting

confidence: 71%

Retrospective Performance Analyses of over Two Million U.S. QuantiFERON Blood Sample Results

Clark

Master

et al. 2021

Microbiol Spectr

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Both the QuantiFERON-TB Gold Plus (QFT-Plus) and the QuantiFERON-TB Gold In-Tube (QFT-GIT) tests are interferon gamma (IFN-γ) release assays (IGRAs) intended to detect in vitro cell-mediated immune responses to Mycobacterium tuberculosis antigens. In this study, we retrospectively analyzed performance data for both the QFT-GIT and QFT-Plus test systems from over 2 million samples.

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Section: Discussionsupporting

confidence: 71%

Retrospective Performance Analyses of over Two Million U.S. QuantiFERON Blood Sample Results

Clark

Master

et al. 2021

Microbiol Spectr

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“…Therefore, QFT-Plus is effective in children and can be a good alternative to TST ( Buonsenso et al 2020 ). This rate is much lower than that reported from previous studies on QFT assay ( Lombardi et al 2018 ; 2019 ; Kay et al 2019 ; Primaturia et al 2020 ) but higher than in this study (0.47%; 1/213). Indeterminate results mostly concerned the children with acute infections (pneumonia) and did not occur in TB children ( Lombardi et al 2018 ; 2019 ).…”

Section: Discussioncontrasting

confidence: 84%

“…This rate is much lower than that reported from previous studies on QFT assay ( Lombardi et al 2018 ; 2019 ; Kay et al 2019 ; Primaturia et al 2020 ) but higher than in this study (0.47%; 1/213). Indeterminate results mostly concerned the children with acute infections (pneumonia) and did not occur in TB children ( Lombardi et al 2018 ; 2019 ). The young age of patients did not adversely affect IGRA response, and QFT-IT positive versus negative results were not age-related ( Critselis et al 2012 ).…”

Section: Discussioncontrasting

confidence: 84%

QuantiFERON-TB Gold Plus Test in Diagnostics of Latent Tuberculosis Infection in Children Aged 1–14 in a Country with a Low Tuberculosis Incidence

Borkowska-Tatar¹,

KRASIŃSKA²,

Augustynowicz–Kopeć³

2021

Polish Journal of Microbiology

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The aim of the study was to evaluate the QuantiFERON-TB Gold Plus (QFT-Plus) test usability in the identification of latent tuberculosis infection (LTBI) in children and the determination of features associated with tuberculin skin test (TST) and QFT-Plus-positive results concerning LTBI. Two-hundred thirteen children aged 1–14 were screened for LTBI due to household contact with TB, suspected TB, or were qualified for biological therapy. The objective of this study was to evaluate the QFT-Plus affectivity as a diagnostic test in the absence of a gold standard (GS) test for the diagnosis of LTBI. The children were diagnosed with QFT-Plus, TST, and culture of TB. The QFT-Plus results were analyzed depending on the children’s age, TST size, and type. In children aged 1–4, the positive predictive value of QFT-Plus was 1, the negative predictive value was 0.94, QFT-Plus sensitivity was 75%, and specificity was 100%. It was observed that in children aged 5–14 years, the level of agreement decreased to the substantial, i.e., 87.2%. Moreover, the negative predictive value was 0.83. QFT-Plus sensitivity was 64%, and specificity was 100%. Statistical analysis of QFT-Plus and TST results showed substantial and almost perfect agreements. Our study suggests that QFT-Plus is helpful in a pediatric practice showing good sensitivity and specificity for LTBI. The BCG vaccine, infections, and concomitant morbidities do not affect QFT-Plus results.

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“…TB was preferred over QFT. IGRAs are not generally recommended below two years of age, but we and others had encouraging results at this age …”

Section: Methodsmentioning

confidence: 74%

Foreign background and older age of children were associated with infection in Swedish tuberculosis contacts

2020

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Aim We present our results using interferon‐gamma release assays in any child <18 years or tuberculin skin tests in Bacille Calmette‐Guérin unvaccinated children for tuberculosis contact investigation in Stockholm, Sweden. Methods During 2000—2019, we investigated 892 children with a median age of seven years. We explored associations between TB infection and characteristics such as closeness to contact, age, sex, BCG status and foreign origin. Results The overall rates were for TB infection 10.2% (n = 91) and for TB disease 1.1% (n = 10). In addition to infectiousness of index case and closeness of contact, foreign background, male sex and increasing age were independently associated with infection. In foreign‐born children, the rates of tuberculosis infection and disease were 18.7% and 3.9%, respectively. In 18/46 (39%) infected foreign‐born children, a baseline negative tuberculosis test supported a diagnosis of recent infection. Conclusion Foreign background, older age and male sex were associated with infection. In a significant proportion of infected children, a previous negative test made recent infection likely.

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QuantiFERON-TB Performs Better in Children, Including Infants, than in Adults with Active Tuberculosis: a Multicenter Study

Cited by 15 publications

References 33 publications

Retrospective Performance Analyses of over Two Million U.S. QuantiFERON Blood Sample Results

Retrospective Performance Analyses of over Two Million U.S. QuantiFERON Blood Sample Results

QuantiFERON-TB Gold Plus Test in Diagnostics of Latent Tuberculosis Infection in Children Aged 1–14 in a Country with a Low Tuberculosis Incidence

Foreign background and older age of children were associated with infection in Swedish tuberculosis contacts

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