A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.

<h4>Background</h4>There are limited data comparing the performance of the two commercially available interferon gamma (IFN-gamma) release assays (IGRAs) for the diagnosis of tuberculosis (TB) in children. We compared QuantiFERON-TB gold In Tube (QFT-IT), T-SPOT.TB and the tuberculin ski...

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Autores principales:	Tom G Connell, Nicole Ritz, Georgia A Paxton, Jim P Buttery, Nigel Curtis, Sarath C Ranganathan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2008
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f7a8cff4815442b092a5ff28a3b42cf3
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spelling	oai:doaj.org-article:f7a8cff4815442b092a5ff28a3b42cf32021-11-25T06:11:42ZA three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.1932-620310.1371/journal.pone.0002624https://doaj.org/article/f7a8cff4815442b092a5ff28a3b42cf32008-07-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/18612425/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>There are limited data comparing the performance of the two commercially available interferon gamma (IFN-gamma) release assays (IGRAs) for the diagnosis of tuberculosis (TB) in children. We compared QuantiFERON-TB gold In Tube (QFT-IT), T-SPOT.TB and the tuberculin skin test (TST) in children at risk for latent TB infection or TB disease.<h4>Methods and findings</h4>The results of both IGRAs were compared with diagnosis assigned by TST-based criteria and assessed in relation to TB contact history. Results from the TST and at least one assay were available for 96 of 100 children. Agreement between QFT-IT and T-SPOT.TB was high (93% agreement, kappa = 0.83). QFT-IT and T-SPOT.TB tests were positive in 8 (89%) and 9 (100%) children with suspected active TB disease. There was moderate agreement between TST and either QFT-IT (75%, kappa = 0.50) or T-SPOT.TB (75%, kappa = 0.51). Among 38 children with TST-defined latent TB infection, QFT-IT gold and T-SPOT.TB assays were positive in 47% and 39% respectively. Three TST-negative children were positive by at least one IGRA. Children with a TB contact were more likely than children without a TB contact to have a positive IGRA (QFT-IT LR 3.9; T-SPOT.TB LR 3.9) and a positive TST (LR 1.4). Multivariate linear regression analysis showed that the magnitude of both TST induration and IGRA IFN-gamma responses was significantly influenced by TB contact history, but only the TST was influenced by age.<h4>Conclusions</h4>Although a high level of agreement between the IGRAs was observed, they are commonly discordant with the TST. The correct interpretation of a negative assay in a child with a positive skin test in clinical practice remains challenging and highlights the need for longitudinal studies to determine the negative predictive value of IGRAs.Tom G ConnellNicole RitzGeorgia A PaxtonJim P ButteryNigel CurtisSarath C RanganathanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 3, Iss 7, p e2624 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tom G Connell Nicole Ritz Georgia A Paxton Jim P Buttery Nigel Curtis Sarath C Ranganathan A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.
description	<h4>Background</h4>There are limited data comparing the performance of the two commercially available interferon gamma (IFN-gamma) release assays (IGRAs) for the diagnosis of tuberculosis (TB) in children. We compared QuantiFERON-TB gold In Tube (QFT-IT), T-SPOT.TB and the tuberculin skin test (TST) in children at risk for latent TB infection or TB disease.<h4>Methods and findings</h4>The results of both IGRAs were compared with diagnosis assigned by TST-based criteria and assessed in relation to TB contact history. Results from the TST and at least one assay were available for 96 of 100 children. Agreement between QFT-IT and T-SPOT.TB was high (93% agreement, kappa = 0.83). QFT-IT and T-SPOT.TB tests were positive in 8 (89%) and 9 (100%) children with suspected active TB disease. There was moderate agreement between TST and either QFT-IT (75%, kappa = 0.50) or T-SPOT.TB (75%, kappa = 0.51). Among 38 children with TST-defined latent TB infection, QFT-IT gold and T-SPOT.TB assays were positive in 47% and 39% respectively. Three TST-negative children were positive by at least one IGRA. Children with a TB contact were more likely than children without a TB contact to have a positive IGRA (QFT-IT LR 3.9; T-SPOT.TB LR 3.9) and a positive TST (LR 1.4). Multivariate linear regression analysis showed that the magnitude of both TST induration and IGRA IFN-gamma responses was significantly influenced by TB contact history, but only the TST was influenced by age.<h4>Conclusions</h4>Although a high level of agreement between the IGRAs was observed, they are commonly discordant with the TST. The correct interpretation of a negative assay in a child with a positive skin test in clinical practice remains challenging and highlights the need for longitudinal studies to determine the negative predictive value of IGRAs.
format	article
author	Tom G Connell Nicole Ritz Georgia A Paxton Jim P Buttery Nigel Curtis Sarath C Ranganathan
author_facet	Tom G Connell Nicole Ritz Georgia A Paxton Jim P Buttery Nigel Curtis Sarath C Ranganathan
author_sort	Tom G Connell
title	A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.
title_short	A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.
title_full	A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.
title_fullStr	A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.
title_full_unstemmed	A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.
title_sort	three-way comparison of tuberculin skin testing, quantiferon-tb gold and t-spot.tb in children.
publisher	Public Library of Science (PLoS)
publishDate	2008
url	https://doaj.org/article/f7a8cff4815442b092a5ff28a3b42cf3
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A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.

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