Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis

A. C C Carvalho, R. F. Schumacher, S. Bigoni, E. Soncini, L. Notarangelo, A. Apostoli, C. Bonfanti, D. Cirillo, P. Mantegani, F. Porta, M. Comelli, A. Matteelli

Research output: Contribution to journalArticle

Abstract

Background: Interferon-gamma release assays (IGRAs) have high specificity and sensitivity for the diagnosis of tuberculosis (TB) infection. However, their role as a screening tool in children with immunodeficiency disorders is still unclear. In the present study, we performed a contact investigation using serial IGRAs on children with immunodeficiency conditions exposed to a contagious TB patient. Methods: Children who were exposed to a contagious TB case underwent serial QuantiFERON® TB Gold In-Tube (QFT-GIT) and T-SPOT ®.TB (T-SPOT) testing. Results: Eighteen children were tested. At the first testing, only two children (11 %) were positive to T-SPOT. Indeterminate results were more frequent with QFT-GIT (35 %) than with T-SPOT (12 %). In the multivariable analysis, a statistically significant association of lymphocyte count 3 (p <0.00005) and low age (p = 0.03) with indeterminate results for the QFT-GIT test but not for T-SPOT (p = 0.10 and p = 0.88, respectively) was found. At the end of October 2012, 15 of the 18 children were alive and none developed active TB disease. Conclusion: T-SPOT provided more determinate results and was less influenced by low age and lymphocytopenia than QFT-GIT in this population of immunodeficient children. These findings suggest that T-SPOT is a more accurate test for the identification of TB infection in young children with lymphocytopenia and should be preferred to QFT-GIT under such specific conditions.

Original languageEnglish
Pages (from-to)827-831
Number of pages5
JournalInfection
Volume41
Issue number4
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Children
  • Interferon-gamma release assays
  • Tuberculosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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    Carvalho, A. C. C., Schumacher, R. F., Bigoni, S., Soncini, E., Notarangelo, L., Apostoli, A., Bonfanti, C., Cirillo, D., Mantegani, P., Porta, F., Comelli, M., & Matteelli, A. (2013). Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis. Infection, 41(4), 827-831. https://doi.org/10.1007/s15010-013-0450-y