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KMID : 1040320160230010018
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Pediatric Infection & Vaccine
2016 Volume.23 No. 1 p.18 ~ p.24
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Discordance between Tuberculin Skin Test and Interferon-gamma Release Assays for Diagnosis of Tuberculosis Infection in Korean Children
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Yoo Ree-Nar
Kim Joon-Il
Kim Seo-Hee
Lee Jin-A
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Abstract
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Purpose: There is a the great diagnostic challenge in pediatric tuberculosis especially in high burden setting. The purpose of this preliminary study is to evaluate the agreement between tuberculin skin test (TST) and interferon-gamma release assay (IGRA) including T-SPOT®.TB and QuantiFERON®-TB Gold (QFT-G) in Korean children.
Method: This retrospective study included children and adolescents who visited to Asan Medical Center to evaluate tuberculosis infection using at least two assays of TST, T-SPOT.TB and QFT-G, from January 2014 to April 2015.
Results: A total of 20 patients were included, whose median age was 13.3 years (range, 3.8-18.1 years), and all of them had history of BCG vaccination. Eleven patients had underlying diseases including 7 patients with immunosuppressant medication. The concordance rate between T-SPOT.TB and QFT-G was 90%. However, the concordance rate between TST and T-SPOT.TB was 50%, and between TST and QFT-G was 42.9%. Specificity for the diagnosis of tuberculosis infection of T-SPOT.TB, QFT-G, and TST was 93.3%, 86.7%, and 58.3%, respectively.
Conclusions: Although there was a discrepancy between TST and IGRA to diagnose tuberculosis, agreement between T-SPOT.TB and QFT-G was relatively high. Further prospective study to validate the clinical usefulness of each assay for immunologic evidence of tuberculosis infection in Korean children will be mandatory.
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KEYWORD
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Tuberculosis, Latent tuberculosis infection, T-spot, Quantiferon test, Children
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