QUANTIFERON®-TB GOLD IN-TUBE PERFORMANCE FOR TUBERCULOSIS DIAGNOSIS IN 0-5 YEARS OF AGE CHILDREN
ESPID Education. de Lauzanne A. Jun 7, 2011; 7726
Dr. Agathe de Lauzanne
Dr. Agathe de Lauzanne

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Abstract
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QuantiFERON®-TB Gold in-tube performance for tuberculosis infection diagnosis in 0-5 years of age children.

Camille Debord1, Agathe De Lauzanne2, Valérie Guérin-El Khourouj1, Nadège Gourgouillon1, Béatrice Pédron1, Joel Gaudelus3, Albert Faye2, and Ghislaine Sterkers1.

1 Laboratory of Immunology, Robert Debré Hospital, AP-HP, Paris VII University, Paris-France.
2 Department of Pediatrics, Robert Debré Hospital, AP-HP, Paris VII University, Paris-France.
3 Department of Pediatrics, Jean Verdier Hospital, AP-HP, Paris VII University, Paris-France.

Background: Interferon-γ-Release Assays (IGRAs) are increasingly used for the diagnosis of tuberculosis infection (TB) in adults. Unknown performance in infants and controversial rate of indeterminate results in <5 years old children limit their pediatric usage.
Method: immunocompetent children (n=82, 0.10 to 5.6 years of-aged; median: 1.8) referred for suspected TB infection or contact with TB and sequentially evaluated for QuantiFERON®-TB Gold In-Tube (QF-TB-IT) reactivity were included for QF-TB-IT performance evaluation.
Results: BCG vaccination rate at birth was high (91%). Active TB was diagnosed in 15 children; 10 had latent TB i.e. recent TB contact and positive Tuberculin-Skin Test (TST); 16 had recent contact with TB but negative TST (healthy contact); the 41 remaining children, with TB excluded, were used as a referent population. The rate of QF-TB-IT indeterminate was 5% in active TB, latent TB and healthy contact children (0% in <2 years; n=23) while 22% in referent population with irrelevant diseases. QF-TB-IT sensitivity and specificity, as determined by positivity in active TB and negativity in controls were 86% and 100% respectively (67% and 100% in <2 years). Nearly half of the children with latent TB (4/9) had QF-TB-IT positivity (2 of 4 were <2 years). Finally, concordance between TST and QF-TB-IT results was high only when considering TST negativity <10mm and positivity >15mm induration diameter respectively.
Conclusion: QF-TB-IT sensitivity and specificity were high and the rate of indeterminate results was low in <0-5 years children with TB or TB contact. QF-TB-IT appears therefore a promising tool for TB diagnosis in young immunocompetent children.
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