Diagnosing TB infection in children: Analysis of discordances using in vitro tests and the tuberculin skin test

N. Altet-Gómez; M. De Souza-Galvao; I. Latorre; C. Milà; M. A. Jiménez; J. Solsona; A. Cantos; J. J. Zamora; J. Ruiz-Manzano; V. Ausina; J. Domínguez

doi:10.1183/09031936.00022710

Diagnosing TB infection in children: Analysis of discordances using in vitro tests and the tuberculin skin test

N. Altet-Gómez, M. De Souza-Galvao, I. Latorre, C. Milà, M. A. Jiménez, J. Solsona, A. Cantos, J. J. Zamora, J. Ruiz-Manzano, V. Ausina, J. Domínguez

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33 Citations (Scopus)

Abstract

The aim of the present study was to compare the performance of the interferon (IFN)-γ tests (QuantiFERON®-TB Gold In-Tube (QFT-G-IT) and T-SPOT®.TB) with the tuberculin skin test (TST) in diagnosing tuberculosis (TB) infection in children, and to analyse discordant results. This was a prospective study including 98 children from contact-tracing studies and 68 children with TST indurations ≥5 mm recruited during public health screenings. Positive IFN-γ tests results were associated with risk of exposure (p<0.0001). T-SPOT.TB was positive in 11 (78.6%) out of 14 cases with active TB and QFT-G-IT in nine (64.3%) out of 14 cases. Sensitised T-cells against Mycobacterium avium were detected in six out of 12 children not vaccinated with bacille Calmette-Guérin (BCG), a TST induration 5-9 mm in diameter and both IFN-γ tests negative. In concordant IFN-γ tests results, a positive correlation was found (p=0.0001) between the number of responding cells and the amount of IFN-γ released. However, in discordant IFN-γ tests results this correlation was negative (p=0.371): an increase in the number of spot-forming cells correlated with a decrease in the amount of IFN-γ released. The use of IFN-γ tests is helpful for the diagnosis of TB infection, avoiding cross-reactions with BCG immunisation and nontuberculous mycobacterial infections. The analysis of highly discordant results requires further investigation to elucidate possible clinical implications. Copyright©ERS 2011.

Original language	English
Pages (from-to)	1166-1174
Journal	European Respiratory Journal
Volume	37
Issue number	5
DOIs	https://doi.org/10.1183/09031936.00022710
Publication status	Published - 1 May 2011

Keywords

Agreement
Children
Interferon-γ release assays
Nontuberculous mycobacterial sensitins
Tuberculin skin test
Tuberculosis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1183/09031936.00022710

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Altet-Gómez, N., De Souza-Galvao, M., Latorre, I., Milà, C., Jiménez, M. A., Solsona, J., Cantos, A., Zamora, J. J., Ruiz-Manzano, J., Ausina, V., & Domínguez, J. (2011). Diagnosing TB infection in children: Analysis of discordances using in vitro tests and the tuberculin skin test. European Respiratory Journal, 37(5), 1166-1174. https://doi.org/10.1183/09031936.00022710

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title = "Diagnosing TB infection in children: Analysis of discordances using in vitro tests and the tuberculin skin test",

abstract = "The aim of the present study was to compare the performance of the interferon (IFN)-γ tests (QuantiFERON{\textregistered}-TB Gold In-Tube (QFT-G-IT) and T-SPOT{\textregistered}.TB) with the tuberculin skin test (TST) in diagnosing tuberculosis (TB) infection in children, and to analyse discordant results. This was a prospective study including 98 children from contact-tracing studies and 68 children with TST indurations ≥5 mm recruited during public health screenings. Positive IFN-γ tests results were associated with risk of exposure (p<0.0001). T-SPOT.TB was positive in 11 (78.6%) out of 14 cases with active TB and QFT-G-IT in nine (64.3%) out of 14 cases. Sensitised T-cells against Mycobacterium avium were detected in six out of 12 children not vaccinated with bacille Calmette-Gu{\'e}rin (BCG), a TST induration 5-9 mm in diameter and both IFN-γ tests negative. In concordant IFN-γ tests results, a positive correlation was found (p=0.0001) between the number of responding cells and the amount of IFN-γ released. However, in discordant IFN-γ tests results this correlation was negative (p=0.371): an increase in the number of spot-forming cells correlated with a decrease in the amount of IFN-γ released. The use of IFN-γ tests is helpful for the diagnosis of TB infection, avoiding cross-reactions with BCG immunisation and nontuberculous mycobacterial infections. The analysis of highly discordant results requires further investigation to elucidate possible clinical implications. Copyright{\textcopyright}ERS 2011.",

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author = "N. Altet-G{\'o}mez and {De Souza-Galvao}, M. and I. Latorre and C. Mil{\`a} and Jim{\'e}nez, {M. A.} and J. Solsona and A. Cantos and Zamora, {J. J.} and J. Ruiz-Manzano and V. Ausina and J. Dom{\'i}nguez",

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Altet-Gómez, N, De Souza-Galvao, M, Latorre, I, Milà, C, Jiménez, MA, Solsona, J, Cantos, A, Zamora, JJ, Ruiz-Manzano, J, Ausina, V & Domínguez, J 2011, 'Diagnosing TB infection in children: Analysis of discordances using in vitro tests and the tuberculin skin test', European Respiratory Journal, vol. 37, no. 5, pp. 1166-1174. https://doi.org/10.1183/09031936.00022710

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T1 - Diagnosing TB infection in children: Analysis of discordances using in vitro tests and the tuberculin skin test

AU - Altet-Gómez, N.

AU - De Souza-Galvao, M.

AU - Latorre, I.

AU - Milà, C.

AU - Jiménez, M. A.

AU - Solsona, J.

AU - Cantos, A.

AU - Zamora, J. J.

AU - Ruiz-Manzano, J.

AU - Ausina, V.

AU - Domínguez, J.

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N2 - The aim of the present study was to compare the performance of the interferon (IFN)-γ tests (QuantiFERON®-TB Gold In-Tube (QFT-G-IT) and T-SPOT®.TB) with the tuberculin skin test (TST) in diagnosing tuberculosis (TB) infection in children, and to analyse discordant results. This was a prospective study including 98 children from contact-tracing studies and 68 children with TST indurations ≥5 mm recruited during public health screenings. Positive IFN-γ tests results were associated with risk of exposure (p<0.0001). T-SPOT.TB was positive in 11 (78.6%) out of 14 cases with active TB and QFT-G-IT in nine (64.3%) out of 14 cases. Sensitised T-cells against Mycobacterium avium were detected in six out of 12 children not vaccinated with bacille Calmette-Guérin (BCG), a TST induration 5-9 mm in diameter and both IFN-γ tests negative. In concordant IFN-γ tests results, a positive correlation was found (p=0.0001) between the number of responding cells and the amount of IFN-γ released. However, in discordant IFN-γ tests results this correlation was negative (p=0.371): an increase in the number of spot-forming cells correlated with a decrease in the amount of IFN-γ released. The use of IFN-γ tests is helpful for the diagnosis of TB infection, avoiding cross-reactions with BCG immunisation and nontuberculous mycobacterial infections. The analysis of highly discordant results requires further investigation to elucidate possible clinical implications. Copyright©ERS 2011.

AB - The aim of the present study was to compare the performance of the interferon (IFN)-γ tests (QuantiFERON®-TB Gold In-Tube (QFT-G-IT) and T-SPOT®.TB) with the tuberculin skin test (TST) in diagnosing tuberculosis (TB) infection in children, and to analyse discordant results. This was a prospective study including 98 children from contact-tracing studies and 68 children with TST indurations ≥5 mm recruited during public health screenings. Positive IFN-γ tests results were associated with risk of exposure (p<0.0001). T-SPOT.TB was positive in 11 (78.6%) out of 14 cases with active TB and QFT-G-IT in nine (64.3%) out of 14 cases. Sensitised T-cells against Mycobacterium avium were detected in six out of 12 children not vaccinated with bacille Calmette-Guérin (BCG), a TST induration 5-9 mm in diameter and both IFN-γ tests negative. In concordant IFN-γ tests results, a positive correlation was found (p=0.0001) between the number of responding cells and the amount of IFN-γ released. However, in discordant IFN-γ tests results this correlation was negative (p=0.371): an increase in the number of spot-forming cells correlated with a decrease in the amount of IFN-γ released. The use of IFN-γ tests is helpful for the diagnosis of TB infection, avoiding cross-reactions with BCG immunisation and nontuberculous mycobacterial infections. The analysis of highly discordant results requires further investigation to elucidate possible clinical implications. Copyright©ERS 2011.

KW - Agreement

KW - Children

KW - Interferon-γ release assays

KW - Nontuberculous mycobacterial sensitins

KW - Tuberculin skin test

KW - Tuberculosis

U2 - 10.1183/09031936.00022710

DO - 10.1183/09031936.00022710

M3 - Article

VL - 37

SP - 1166

EP - 1174

IS - 5

ER -

Diagnosing TB infection in children: Analysis of discordances using in vitro tests and the tuberculin skin test

Abstract

Keywords

UN SDGs

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