Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis

Diagnosis of active tuberculosis (TB) in children remains difficult. This study aimed at evaluating the ability of interferon-gamma release assays (IGRAs) in the detection of active TB in human immunodeficiency virus-negative children vaccinated with Bacille Calmette–Guérin and investigating the ef...

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Main Authors: Li, Tao, Bao, Lei, Diao, Ni, Sun, Feng, Gao, Yan, Wong, Ka-Wing, Xi, Xiuhong, Liu, Xuhui, Wang, Sen, Wu, Jing, Hui, Ma, Fan, Xiaoyong, Zhang, Ying, Zhang, Wenhong, Lu, Shuihua
Format: Online
Language:English
Published: Springer International Publishing 2014
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522271/
id pubmed-4522271
recordtype oai_dc
spelling pubmed-45222712015-08-03 Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis Li, Tao Bao, Lei Diao, Ni Sun, Feng Gao, Yan Wong, Ka-Wing Xi, Xiuhong Liu, Xuhui Wang, Sen Wu, Jing Hui, Ma Fan, Xiaoyong Zhang, Ying Zhang, Wenhong Lu, Shuihua Original Article Diagnosis of active tuberculosis (TB) in children remains difficult. This study aimed at evaluating the ability of interferon-gamma release assays (IGRAs) in the detection of active TB in human immunodeficiency virus-negative children vaccinated with Bacille Calmette–Guérin and investigating the effect of prednisolone treatment on the IGRAs performance. Among the 162 children with suspected TB disease recruited in China, 60 were tested with QuantiFERON-TB Gold In Tube (QFT-GIT) and 102 were tested with T-SPOT.TB. QFT-GIT presented a sensitivity of 83.9 % (95 % CI 66.9–93.4 %) and a specificity of 88.5 % (95 % CI 70.2–96.8 %), while T-SPOT.TB had a sensitivity of 75.9 % (95 % CI 63.4–85.2 %) and a specificity of 94.7 % (95 % CI 81.8–99.5 %). The positive predictive value was high in both assays, 92.9 % for QFT-GIT and 95.7 % for T-SPOT.TB. In total of these two kinds of IGRAs, false negative rate was significantly higher in children receiving systemic prednisolone (1 mg/kg/day) therapy for >1 week (two tested with T-SPOT.TB and five tested with QFT-GIT) than in those with ≤1 week of prednisolone therapy and without prednisolone therapy (57.1 vs. 18.3 %, p = 0.035). There was no significant difference of the positive rate of both tests in children <5 years old compared with those ≥5 years old. Both types of IGRAs showed good diagnostic values in detecting childhood TB before microbiological evidence was available. Glucocorticoids had a significant negative influence on IGRAs if treated for >1 week. Age made no difference on the performance of these tests in children. Springer International Publishing 2014-06-13 2015 /pmc/articles/PMC4522271/ /pubmed/24925641 http://dx.doi.org/10.1007/s10238-014-0296-3 Text en © The Author(s) 2014 Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Li, Tao
Bao, Lei
Diao, Ni
Sun, Feng
Gao, Yan
Wong, Ka-Wing
Xi, Xiuhong
Liu, Xuhui
Wang, Sen
Wu, Jing
Hui, Ma
Fan, Xiaoyong
Zhang, Ying
Zhang, Wenhong
Lu, Shuihua
spellingShingle Li, Tao
Bao, Lei
Diao, Ni
Sun, Feng
Gao, Yan
Wong, Ka-Wing
Xi, Xiuhong
Liu, Xuhui
Wang, Sen
Wu, Jing
Hui, Ma
Fan, Xiaoyong
Zhang, Ying
Zhang, Wenhong
Lu, Shuihua
Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis
author_facet Li, Tao
Bao, Lei
Diao, Ni
Sun, Feng
Gao, Yan
Wong, Ka-Wing
Xi, Xiuhong
Liu, Xuhui
Wang, Sen
Wu, Jing
Hui, Ma
Fan, Xiaoyong
Zhang, Ying
Zhang, Wenhong
Lu, Shuihua
author_sort Li, Tao
title Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis
title_short Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis
title_full Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis
title_fullStr Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis
title_full_unstemmed Influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis
title_sort influencial factors of the performance of interferon-γ release assays in the diagnosis of childhood tuberculosis
description Diagnosis of active tuberculosis (TB) in children remains difficult. This study aimed at evaluating the ability of interferon-gamma release assays (IGRAs) in the detection of active TB in human immunodeficiency virus-negative children vaccinated with Bacille Calmette–Guérin and investigating the effect of prednisolone treatment on the IGRAs performance. Among the 162 children with suspected TB disease recruited in China, 60 were tested with QuantiFERON-TB Gold In Tube (QFT-GIT) and 102 were tested with T-SPOT.TB. QFT-GIT presented a sensitivity of 83.9 % (95 % CI 66.9–93.4 %) and a specificity of 88.5 % (95 % CI 70.2–96.8 %), while T-SPOT.TB had a sensitivity of 75.9 % (95 % CI 63.4–85.2 %) and a specificity of 94.7 % (95 % CI 81.8–99.5 %). The positive predictive value was high in both assays, 92.9 % for QFT-GIT and 95.7 % for T-SPOT.TB. In total of these two kinds of IGRAs, false negative rate was significantly higher in children receiving systemic prednisolone (1 mg/kg/day) therapy for >1 week (two tested with T-SPOT.TB and five tested with QFT-GIT) than in those with ≤1 week of prednisolone therapy and without prednisolone therapy (57.1 vs. 18.3 %, p = 0.035). There was no significant difference of the positive rate of both tests in children <5 years old compared with those ≥5 years old. Both types of IGRAs showed good diagnostic values in detecting childhood TB before microbiological evidence was available. Glucocorticoids had a significant negative influence on IGRAs if treated for >1 week. Age made no difference on the performance of these tests in children.
publisher Springer International Publishing
publishDate 2014
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522271/
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