engleski

Concordance between tuberculin skin test and interferon-gamma release assay in Mycobacterium tuberculosis infected children aged up to five years

Background and aim: The aim of the present study was to improve diagnosis of latent tuberculosis infection (LTBI) in BCG-vaccinated children aged up to 5 years, with documented exposure to active tuberculosis (TB) and to assess concordance between IGRA and TST results. Methods: A total of 142 BCG-vaccinated children aged 1 month to 5 years were investigated because of a history of exposure to a case of active TB. Results were stratified according to their TST cut-off value ≥ 10 mm (BCG vaccinated). Ex vivo T-cell-based IGRA was performed by use of QuantiFERON-TB Gold In Tube assay (Cellestis Ltd., Carnegie, Australia). Results: IGRA-positive/TST-positive concordance was confirmed in 10 % of children, and IGRA-negative/TST-negative concordance in 79% of children. In remaining 11% of children IGRA/TST discordance was conformed. The two tests showed a moderate overall concordance (89% ; κ = 0.591). IFN-γ determination resulted in one indeterminate response (0.7%), attributable to low mitogen. Conclusion: Children with TST-negative/IGRA-positive discordance required isoniazid prophylaxis. In TST-positive/IGRA-negative discordance, serial determination of IFN-γ is needed to provide reliable diagnosis, that will help to decide whether to use isoniazid prophylaxis or not.

dijete; test oslobađanja interferona-γ; latentna tuberkulozna infekcija

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