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Performance of the QuantiFERON-TB Gold Assay Among HIV-infected Children with Active Tuberculosis in France

Hormi, Myriam PhD; Khourouj, Valérie Guérin-El PhD; Pommelet, Virginie MD; Jeljeli, Mohamed MD; Pédron, Béatrice PhD, MD; Diana, Jean-Sébastien MD; Faye, Albert PhD, MD; Sterkers, Ghislaine PhD, MD
The Pediatric Infectious Disease Journal: Post Acceptance: September 05, 2017
doi: 10.1097/INF.0000000000001774
HIV Reports: PDF Only

Background:

Data regarding the use of QuantiFERON to assist the diagnosis of active tuberculosis (TB) in HIV-infected children is limited, especially in countries with low incidence of TB/HIV co-infection.

Methods:

QuantiFERON results were analyzed in 63 HIV-infected children who presented to our hospital in Paris, France. Seventeen HIV-uninfected children with active TB (4 culture-confirmed) were included for comparison.

Results:

The 63 HIV-infected children (median age: 11 years) had 113 QuantiFERON tests. Thirty-four (54%) were born in sub-Saharan Africa. Vertical HIV transmission was documented for 50/52 (96%) and stage III HIV-infection for 30/50 children (60%).

Over the study period, active TB was diagnosed in 7/63 HIV-infected children (3 culture-confirmed). Additional ongoing or previous opportunistic infections were present in 4/7.

QuantiFERON results were positive in 2/7 HIV-infected children with active TB (sensitivity: 29%) and 16/17 HIV-uninfected children with active TB (sensitivity 94%).

At initial QuantiFERON testing of the 63 HIV-infected children, 8 (13%) had positive results (1, active TB; 5, latent TB; 2, previous TB) and 51 (81%) had negative results. Of 33 children with repeat testing after an initially positive or negative result, the only change was one conversion from a negative to a positive result at the onset of active TB.

The four children (6%) with indeterminate quantiFERON results had a concomitant opportunistic infection, Results of repeat testing after clinical stabilization was negative in all four.

Conclusion:

QuantiFERON testing performed poorly for active TB diagnosis in this series of children with advanced HIV infection.

The authors have no conflicts of interest or funding to disclose.

ACKNOWLEDGEMENTS: We greatly thank Judith Tholle, Priscilia Egremonte, Emeline Vasseur, Guylaine Boiry and Imane Baatout for performing QFT assays and Céline Neto for typing the manuscript. We also greatly thank the patients for participating to the study and the nurses of the pediatric department for performing blood sampling.

Corresponding author: Pr. Ghislaine STERKERS, Hôpital Robert Debré - Laboratoire d’Immunologie, 48, Boulevard Sérurier, 75019 Paris, France. Tel: +33.1.40.03.53.05 - Fax: +33.1.40.03.47.76, E-mail: ghislaine.sterkers@aphp.fr

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