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KMID : 0605820080150010051
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Korean Journal of Pediatric Infectious Diseases
2008 Volume.15 No. 1 p.51 ~ p.57
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Usefulness of Interferon-r Measurement Following Stimulation of Tuberculosis-specific Aantigens for Diagnosis of Latent Tuberculosis Infection in Children Exposed to Pulmonary Tuberculosis
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Sung Ji-Yeon
Choi Eun-Hwa
Lee Jin-A
Lee Hoan-Jong
Park Kyoung-Un
Kim So-Hee
Yang Mi-Ae
Kim Nam-Hee
Kim Joo-Hwa
Eun Byung-Wook
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Abstract
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Purpose : Whole blood interferon-γ assay was developed and many studies showed its usefulness in diagnosing tuberculosis (TB) including latent tuberculosis infection (LTBI). However, assessment in children has been limited. This study was undertaken to evaluate the usefulness of QuantiFERON-TB Gold for the diagnosis of LTBI in children exposed to
pulmonary TB.
Methods : Children who visited Seoul National University Bundang Hospital with a history of TB exposure were enrolled from January 2006 to December 2007. They were evaluated with chest x-rays, tuberculin skin test (TST) and QuantiFERON-TB Gold test. TST was retested 3 months later for those with initial negative reactivity. Definition of LTBI was
made on the basis of the TST reactivity.
Results : Among the 103 children with a history of TB exposure, 49 children were tested with chest x-ray, TST, and QuantiFERON-TB Gold. Twenty-two were males. Median age was 7.5 years (range; 3 months to 14.7 years). According to TST reactivity, LTBI was in 8 (19%), no infection was in 21 (50%), possible LTBI was in 13 (31%). QuantiFERON-TB Gold test was positive in 5 of the 49 subjects (10%); 3 of the 13 subjects (23.1%) in unknown status,
1 of the 8 subjects (13%) in LTBI, and 1 of the 21 subjects (5%) without infection. The agreement between the QuantiFERON-TB Gold and the TST was poor (κ=0.101).
Conclus ion : QuantiFERON-TB Gold showed poor sensitivity for the diagnosis of LTBI in children with exposure to TB. QuantiFERON-TB Gold alone does not seem to be useful in the diagnosis of LTBI in children.
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KEYWORD
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Latent Tuberculosis Infection, Tuberculin skin test, Interferon gamma assay, Children
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