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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31819abf6b
Original Studies

Interferon-Gamma Release Assay Improves the Diagnosis of Tuberculosis in Children

Bianchi, Leila MD; Galli, Luisa MD; Moriondo, Maria BSc; Veneruso, Giuseppina MD, PhD; Becciolini, Laura BSc, PhD; Azzari, Chiara MD, PhD; Chiappini, Elena MD, PhD; de Martino, Maurizio MD

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Background: Interferon-γ release assays (IGRAs) have been recently developed for the diagnosis of tuberculosis (TB) infection. The aim of the present study was to evaluate the performance of an enzyme-linked immunosorbent assay (ELISA)-based IGRA for detecting TB in children.

Methods: A prospective study in 336 children at risk for TB infection was carried out. All children were tested with tuberculin skin test (TST) and a commercial ELISA-based IGRA [QuantiFERON-TB Gold In-Tube (Cellestis)].

Results: TST were positive in 58 of 336 (17.3%) and IGRA in 60 of 336 (17.9%) children. Two (0.6%) IGRA results were indeterminate. The overall agreement between the 2 tests was intermediate (86.2%, κ = 0.533). IGRA was positive in 15 of 16 (93.8%) children with active pulmonary TB. The discordant pattern IGRA−/TST+ was significantly associated with Bacille Calmette-Guérin (BCG) vaccination. Among IGRA+ children (excluding cases of TB disease), TST− were significantly younger than TST+ children.

Conclusions: The good agreement between positive IGRA and active TB disease suggests a good sensitivity of IGRA. Discrepancies between IGRA and TST can be a result of higher specificity of IGRA that is not influenced by previous BCG vaccination. IGRA may be more sensitive in children younger than 48 months.

© 2009 Lippincott Williams & Wilkins, Inc.


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