Relating @entity378 Characteristics to QuantiFERON- @entity378 -Gold and Tuberculin Skin Test Results in the Toronto Pediatric XXXX Clinic.

@entity1 @entity9178 @entity378 @entity272
BACKGROUND: Few data relate interferon-y-release-assay results in @entity1 to source case sputum status, the best predictor of infectiousness of @entity378 ( @entity378 ) @entity1 . We evaluated the QuantiFERON-Gold-in-tube assay (QFT) and @entity272 ( @entity272 ) in @entity1 with different types of @entity378 exposure. METHODS: The @entity272 and QFT were performed in referred @entity378 -exposed @entity1 and adolescents who had not undergone prior @entity272 screening (tested in parallel), and the QFT was performed in referred @entity272 -positive individuals. Source case characteristics were obtained from referring public health units. We excluded @entity1 with known immunocompromising conditions and those known to have @entity378 disease at the time of evaluation. RESULTS: For 103 @entity1 tested in parallel, overall test agreement was very good in the Bacillus Calmette-Guerein (BCG) unimmunized contacts (k = 0.83) and contacts of household smear-positive (HS+) cases (k = 0.67), but test agreement was poor in those with lower-risk contact (k = 0.34). Only 3 of 59 HS+ @entity1 were QFT-positive and @entity272 -negative. On multivariate analysis, a positive QFT was strongly associated with HS+ exposure (odds ratio [OR], 6.6; 95% confidence interval [CI], 2.2-20]) but not BCG; and a positive @entity272 was associated with BCG alone. For 92 referred @entity272 -positive individuals, the QFT was negative in 21% of HS+ contacts, 65% of lower-risk contacts (OR, 6.8; 95% CI, 1.9-25), and 82% of the @entity1 with unknown contact history (OR, 15.5; 95% CI, 5-54). Application of the Canadian 2010 guidelines would exclude from treatment 43 (72%) of the 73 @entity272 +, QFT- @entity1 . CONCLUSIONS: For close contacts of HS+ individuals, the QFT added little sensitivity to the @entity272 for detection of @entity378 . The QFT correlated much better with exposure than the @entity272 , especially in BCG-immunized @entity1 , and it has the greatest potential benefit for evaluation of those at lower risk of @entity9178 .
