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Accuracy of QuantiFERON-TB Gold-PLUS Test for the Diagnosis of Mycobacterium tuberculosis infection in Children.

QuantiFERON-TB Gold-PLUS 试验诊断儿童结核分枝杆菌感染的准确性。

  • 影响因子:3.65
  • DOI:10.1128/JCM.00272-20
  • 作者列表:"Buonsenso D","Delogu G","Perricone C","Grossi R","Careddu A","De Maio F","Palucci I","Sanguinetti M","Valentini P","Sali M
  • 发表时间:2020-03-30
Abstract

Background. Compared to its predecessor QuantiFERON-TB Gold in Tube (QFT-IT), QuantiFERON-TB Gold Plus (QFT-Plus) contains an additional antigen tube (TB2), stimulating both CD4+ and CD8+ T-cells. The ability to discriminate CD4+ and CD8+ responses is suggested to be useful in differentiating stages of M. tuberculosis infection. While QFT-Plus has already been evaluated in adults, there are not enough data in children evaluated for suspected active tuberculosis (TB) or latent TB infection (LTBI).Methods. A prospective cross-sectional study was conducted among children aged 0 to 17 years who were evaluated for suspected active TB or screened for LTBI. All children underwent QFT-Plus and further clinical, radiological, microbiological analyses according to clinical scenario.Results. Of the 198 children enrolled, 43 (21.7 %) were tested because of suspicion of active TB: 12/43 (27.9%) were diagnosed with active TB, and among these 10/12 (83.3%) had a positive QFT-Plus assay. Of the 155 children screened for LTBI 18 (11.6%) had a positive QFT-Plus and 5 (2.5%) had an indeterminate result. TB1 and TB2 quantitative responses were not able to discriminate active disease from latent infection. The percent agreement between TB1 and TB2 was 100%.Conclusions. QFT-Plus assay showed good sensitivity for active TB and was particularly useful for the evaluation of children with suspected LTBI, giving a low rate of indeterminate results in this group. More studies are needed to properly evaluate QFT-Plus ability in discriminating active disease from latent infection.

摘要

背景。与其前身 QuantiFERON-TB Gold in Tube (QFT-IT) 相比,QuantiFERON-TB Gold Plus (QFT-Plus) 含有额外的抗原管 (TB2),同时刺激 CD4 + 和 CD8 + T 细胞。区分 CD4 + 和 CD8 + 反应的能力被认为在鉴别结核分枝杆菌感染的阶段是有用的。虽然 QFT-Plus 已经在成人中进行了评估,但在儿童中评估疑似活动性结核病 (TB) 或潜伏性结核感染 (LTBI) 的数据不足。对 0 ~ 17 岁疑似活动性结核病或筛查 LTBI 的儿童进行前瞻性横断面研究。所有患儿均根据临床情况进行 QFT-Plus 和进一步的临床、放射学、微生物学分析。结果。在登记的 198 名儿童中,43 名 (21.7%) 因怀疑活动性结核病而接受检测: 12/43 名 (27.9%) 被诊断患有活动性结核病,其中 10/12 名 (83.3%) QFT-Plus 检测阳性。在筛查 LTBI 的 155 例儿童中,18 例 (11.6%) QFT-Plus 阳性,5 例 (2.5%) 结果不确定。TB1 和 TB2 定量反应不能区分活动性疾病和潜伏感染。TB1 和 TB2 之间的一致性百分比为 100%。结论。QFT-Plus 检测对活动性 TB 显示出良好的敏感性,对疑似 LTBI 患儿的评估特别有用,在该组中给出的不确定结果率较低。需要更多的研究来正确评价 QFT-Plus 区分活动性疾病和潜伏感染的能力。

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