Usefulness of interferon-γ release assay for the diagnosis of latent tuberculosis infection in young children.
10.3345/kjp.2016.59.6.256
- Author:
Ki Wook YUN
1
;
Young Kwang KIM
;
Hae Ryun KIM
;
Mi Kyung LEE
;
In Seok LIM
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. pedwilly@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Interferon-gamma release assay;
Tuberculin skin test;
Latent tuberculosis infection;
Child
- MeSH:
Child*;
Diagnosis*;
Humans;
Interferon-gamma Release Tests;
Latent Tuberculosis*;
Skin Tests;
Tuberculin;
Tuberculosis
- From:Korean Journal of Pediatrics
2016;59(6):256-261
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Latent tuberculosis infection (LTBI) in young children may progress to severe active tuberculosis (TB) disease and serve as a reservoir for future transmission of TB disease. There are limited data on interferon-γ release assay (IGRA) performance in young children, which our research aims to address by investigating the usefulness of IGRA for the diagnosis of LTBI. METHODS: We performed a tuberculin skin test (TST) and IGRA on children who were younger than 18 years and were admitted to Chung-Ang University Hospital during May 2011-June 2015. Blood samples for IGRA were collected, processed, and interpreted according to manufacturer protocol. RESULTS: Among 149 children, 31 (20.8%) and 10 (6.7%) were diagnosed with LTBI and active pulmonary TB, respectively. In subjects lacking contact history with active TB patients, TST and IGRA results were positive in 41.4% (29 of 70) and 12.9% (9 of 70) subjects, respectively. The agreement (kappa) of TST and IGRA was 0.123. The control group, consisting of non-TB-infected subjects, showed no correlation between age and changes in interferon-γ concentration after nil antigen, TB-specific antigen, or mitogen stimulation in IGRAs (P=0.384, P=0.176, and P=0.077, respectively). In serial IGRAs, interferon-γ response to TB antigen increased in IGRA-positive LTBI subjects, but did not change considerably in initially IGRA-negative LTBI or control subjects. CONCLUSION: The lack of decrease in interferon-γ response in young children indicates that IGRA could be considered for this age group. Serial IGRA tests might accurately diagnose LTBI in children lacking contact history with active TB patients.
