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

Hormi, Myriam PhD*; Guérin-El Khourouj, Valérie 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: April 2018 - Volume 37 - Issue 4 - p 339–344
doi: 10.1097/INF.0000000000001774
HIV Reports

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

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 yr) had 113 QuantiFERON tests. Thirty-four (54%) were born in sub-Saharan Africa. Vertical HIV transmission was documented for 50 of 52 (96%) and stage III HIV-infection for 30 of 50 children (60%). Over the study period, active TB was diagnosed in 7 of 63 HIV-infected children (3 culture-confirmed). Additional ongoing or previous opportunistic infections were present in 4 of 7. QuantiFERON results were positive in 2 of 7 HIV-infected children with active TB (sensitivity: 29%) and 16 of 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 4 children (6%) with indeterminate quantiFERON results had a concomitant opportunistic infection. Results of repeat testing after clinical stabilization were negative in all 4.

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

*Laboratory of Immunology, and Department of Pediatric Infectious Disease, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Diderot, Sorbonne Paris Cité, France.

Accepted for publication March 25, 2017.

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

Address for correspondence: Ghislaine Sterkers, PhD, MD, Hôpital Robert Debré—Laboratoire d’Immunologie, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Diderot, 48, Boulevard Sérurier, 75019 Paris, France. E-mail:

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