Long-incubation time-interferon-gamma release assays in response to PPD-, ESAT-6- and/or CFP-10 for the diagnosis of Mycobacterium tuberculosis infection in children
[en] Background: Diagnosis of childhood active tuberculosis (aTB) or latent Mycobacterium tuberculosis (Mtb) infection (LTBI) remains a challenge, and replacement of tuberculin skin tests (TST) by commercialized interferon-gamma release assays (IGRA) is not currently recommended.
Methods: 266 children between 1 month and 15 years of age, 214 being at risk of recent Mtb infection and 51 being included as controls, were prospectively enrolled. According results of clinical evaluation, TST, chest X-Ray and microbiology, children were classified as non-infected, LTBI or aTB. Long-incubation time PPD-, ESAT-6-, and CFP-10-IGRA were performed and evaluated for their accuracy to correctly classify the children.
Results: Whereas both TST and PPD-IGRA were suboptimal to detect aTB, combining CFP-10-IGRA with TST or with PPD-IGRA allowed us to detect all the children with aTB, with 96% specificity for children who were positive for CFP-10-IGRA. Moreover, combination of CFP-10- and PPD-IGRA also detected 96% of children classified as LTBI, but a strong IFN-γ response to CFP-10 (>500 pg/ml) was highly suggestive of aTB at least among children less than 3 years old.
Conclusions: Long-incubation time CFP-10- and PPD-IGRA should help the clinicians to identify quickly aTB or LTBI in young children.
Disciplines :
Immunology & infectious disease
Author, co-author :
Schepers, Kinda; Université Libre de Bruxelles - ULB > Laboratory of Vaccinology and Mucosal Immunity
Mouchet, Françoise
Dirix, Violette
De Schutter, Iris
Kersten, Jotzo
Verscheure, Virginie
Geurts, Pierre ; Université de Liège - ULiège > Dép. d'électric., électron. et informat. (Inst.Montefiore) > Algorith. des syst. en interaction avec le monde physique
Mahavir, Singh
Van Vooren, Jean-Paul
Mascart, Françoise; Université Libre de Bruxelles - ULB > Laboratory of Vaccinology and Mucosal Immunity
Language :
English
Title :
Long-incubation time-interferon-gamma release assays in response to PPD-, ESAT-6- and/or CFP-10 for the diagnosis of Mycobacterium tuberculosis infection in children
Publication date :
February 2014
Journal title :
Clinical and Vaccine Immunology
ISSN :
1556-6811
eISSN :
1556-679X
Publisher :
American Society for Microbiology (ASM), Washington, United States - District of Columbia
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