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.
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