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Soon, Lim, Kim, Namgoong, Cha, Uh, and Chun: A Tapping the usefulness of Whole Blood Interferon-γ Assay for Diagnosing Tuberculosis Infection in Children
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 68(5): 280-285.

Published online: 31 May 2010

DOI: https://doi.org/10.4046/trd.2010.68.5.280

A Tapping the usefulness of Whole Blood Interferon-γ Assay for Diagnosing Tuberculosis Infection in Children

Eu-Gene Soon, M.D.1, Baek Keun Lim, M.D.1, Hwang Min Kim, M.D.1, Mee Kyung Namgoong, M.D.1, Byung Ho Cha, M.D.1, Young Uh, M.D.2, Jin-Kyong Chun, M.D.1

1Department of Pediatrics, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.

2Department of Laboratory Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.

Address for correspondence: Jin-Kyong Chun, M.D. Department of Pediatrics and Adolescent Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, 162, Ilsan-dong, Wonju 220-701, Korea. Phone: 82-33-741-1281, Fax: 82-33-732-6229, jkchunped@yonsei.ac.kr

Received 24 March 2010       Accepted 10 May 2010

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

QuantiFERON®-TB Gold In Tube (QFT-G IT) has been used for diagnosing latent tuberculosis infection and active tuberculosis (TB) since 2007. However, there has not been enough data on QFT-G IT for universal use in children. In this study, we evaluated the clinical usefulness of the QFT-G IT in pediatric practice.

Methods

We retrospectively reviewed the clinical records of 70 patients younger than 18 years of age who had taken QFT-G IT and had a tuberculin skin test (TST) between July 2007 and July 2009 at Wonju Christian Hospital. The subjects were divided into two groups, asymptomatic TB exposure group and disease group. Four patients who were taking immunosuppressants during the study period were excluded.

Results

A total of 66 immunocompetent children were included in this study. Among 27 asymptomatic children who had contact histories of TB, 6 (22.2%) were found to be positive by QFT-G IT. Eleven (40.7%) and 5 (18.5%) children were found to be positive by TST with cutoff values of ≥5 mm and ≥10 mm, respectively. Agreement was fair to good between QFT-G IT and TST (κ=0.59: cutoff value ≥5 mm, κ=0.7: cutoff value ≥10 mm). In disease group, 14 patients (35.9%) were diagnosed with active tuberculosis, 8/14 (57.1%) were positive on TST and 9/14 (64.3%) on QFT-G IT. The positive rate of acid-fast bacilli smear, TB-polymerase chain reaction, and culture for tuberculosis was 11% (1/9), 27.3% (3/11) and 33.3% (3/9), respectively.

Conclusion

Our data support that the QFT-G IT can be used as an additional diagnostic tool for latent and active tuberculosis infection in children.

Keywords: Child, Tuberculosis, Interferon-gamma Release Assay

Figures and Tables

Table 1
Demographic characteristics of patients
trd-68-280-i001

BCG: bacilli Calmette Guérin vaccination; TST: tuberculin skin test; QFT-G IT: QuantiFERON®-TB Gold In Tube; LTBI: latent tuberculosis infection; TB: tuberculosis.

Table 2
Agreement between TST and QFT-G IT when cut off value is 5 mm or 10 mm in asymptomatic patients who had contact histories of TB
trd-68-280-i002

TST: tuberculin skin test; QFT-G IT: QuantiFERON®-TB Gold In Tube; TB: tuberculosis; Ind.: indeterminate.

Table 3
Final diagnoses and the results of screening for tuberculosis in disease group
trd-68-280-i003

Values are presented as number.

QFT-G IT: QuantiFERON®-TB Gold In Tube; TST: tuberculin skin test; TB: tuberculosis; FUO: fever of unknown origin; Ind.: indeterminate.

Table 4
The positive rate of AFB smear, culture for tuberculosis, PCR assay, QFT-G IT, and TST in patients with active tuberculosis
trd-68-280-i004

AFB: acid fast bacilli; PCR: polymerase chain reaction; QFT-G IT: QuantiFERON®-TB Gold In Tube; TST: tuberculin skin test; TB: tuberculosis.

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