QuantiFERON-TB Performs Better in Children, Including Infants, than in Adults with Active Tuberculosis: a Multicenter Study.
Immunological tests, including the QuantiFERON-TB Gold In-Tube (QFT-IT) assay, represent an important aid for diagnosing active tuberculosis (TB) and latent TB infections in children, but concerns about their use in children <5 years of age persist. This is a multicenter retrospective study comparing a population of 226 children to 521 adults with pulmonary or extrapulmonary TB. The aim was to evaluate the QFT-IT performance, analyzing both qualitative and quantitative results, according to age, birthplace, and disease localization. Compared to culture, QFT-IT sensitivity was 93.9%, 100%, and 94.4% in children ≤2, 2 to 5, and 5 to 16 years of age, respectively, and was significantly higher than that in adults (81.0%) (P < 0.0001). The rate of indeterminate test results for children (2.2%) was significantly lower than that for adults (5.2%) (P < 0.0001). In children, QFT-IT sensitivity was not affected by disease localization or birthplace (Italy born versus foreign born). Interferon gamma (IFN-γ) values in response to TB antigen and mitogen were significantly higher in children than in adults (TB antigen, median of 10 versus 1.66 IU IFN-γ/ml; mitogen, median of 10 versus 6.70 IU IFN-γ/ml; P < 0.0001). In summary, this study supports the use of QFT-IT as a complementary test for the diagnosis of pediatric TB even under 2 years of age. Our observations could be applicable to the new version of the test, QuantiFERON-TB Gold Plus, which has recently been shown to have similar sensitivity in active TB, although data in children are still lacking.
['Lombardi|Giulia|G|', 'Pellegrino|Maria Teresa|MT|', 'Denicolò|Agnese|A|', 'Corsini|Ilaria|I|', 'Tadolini|Marina|M|', 'Bergamini|Barbara Maria|BM|', 'Meacci|Marisa|M|', 'Garazzino|Silvia|S|', 'Peracchi|Marta|M|', 'Lanari|Marcello|M|', 'Re|Maria Carla|MC|', 'Dal Monte|Paola|P|']
D000293:Adolescent D000328:Adult D002648:Child D002675:Child, Preschool D005260:Female D006801:Humans D007223:Infant D007231:Infant, Newborn D059425:Interferon-gamma Release Tests D055985:Latent Tuberculosis D008297:Male D009169:Mycobacterium tuberculosis D012189:Retrospective Studies D012680:Sensitivity and Specificity D014376:Tuberculosis D055815:Young Adult
children adults tuberculosis QuantiFERON-TB Gold In-Tube age active disease interferon gamma values