Evaluation of QuantiFERON microtube, using 0.9 mL blood, for diagnosing tuberculosis infection

TY - JOUR

T1 - Evaluation of QuantiFERON microtube, using 0.9 mL blood, for diagnosing tuberculosis infection

AU - Rose, Michala V

AU - Kimaro, Godfather

AU - Kroidl, Inge

AU - Hoelscher, Michael

AU - Bygbjerg, Ib C

AU - Mfinanga, Sayoki M

AU - Ravn, Pernille

PY - 2013/4/1

Y1 - 2013/4/1

N2 - The performance of QuantiFERON microtube (QFT-MT), using 0.9 mL blood, and QuantiFERON-TB Gold in-tube test (QFT-IT) (3 mL blood), for diagnosing tuberculosis (TB) was compared in children and adults in an endemic setting. In 152 children with suspected TB and 87 adults with confirmed TB, QFT-IT was compared with two QFT-MT concentrations (QFT-MT A and B). Proportions of positive and indeterminate results, interferon (IFN)-γ responses, interassay agreement and sensitivity were assessed. We found similar proportions of indeterminate results, levels of IFN-γ and comparable sensitivity. The interassay agreement was moderate in all children (QFT-IT versus QFT-MT A: 85%, k50.44 and QFT-IT versus QFT-MT B: 88%, k=50.50) and adults (QFT-IT versus QFT-MT A: 88%, k50.50 and QFT-IT versus QFT-MT B: 89%, k=50.49). Sensitivity was low (QFT-IT 23%, QFTMT A 18% and B 19%) in children with confirmed or highly probable TB compared with adults (83%, 86% and 88%, respectively). The QFT-MT test can be reliably performed using less than one-third of the blood volume used in QFT-IT. The reduced volume may be useful for research and future diagnosis of paediatric TB. The poor sensitivity and high indeterminate rate of both IFN-c release assays in severely ill children, with immature or impaired immunity in an endemic setting, warrants further investigations.

AB - The performance of QuantiFERON microtube (QFT-MT), using 0.9 mL blood, and QuantiFERON-TB Gold in-tube test (QFT-IT) (3 mL blood), for diagnosing tuberculosis (TB) was compared in children and adults in an endemic setting. In 152 children with suspected TB and 87 adults with confirmed TB, QFT-IT was compared with two QFT-MT concentrations (QFT-MT A and B). Proportions of positive and indeterminate results, interferon (IFN)-γ responses, interassay agreement and sensitivity were assessed. We found similar proportions of indeterminate results, levels of IFN-γ and comparable sensitivity. The interassay agreement was moderate in all children (QFT-IT versus QFT-MT A: 85%, k50.44 and QFT-IT versus QFT-MT B: 88%, k=50.50) and adults (QFT-IT versus QFT-MT A: 88%, k50.50 and QFT-IT versus QFT-MT B: 89%, k=50.49). Sensitivity was low (QFT-IT 23%, QFTMT A 18% and B 19%) in children with confirmed or highly probable TB compared with adults (83%, 86% and 88%, respectively). The QFT-MT test can be reliably performed using less than one-third of the blood volume used in QFT-IT. The reduced volume may be useful for research and future diagnosis of paediatric TB. The poor sensitivity and high indeterminate rate of both IFN-c release assays in severely ill children, with immature or impaired immunity in an endemic setting, warrants further investigations.

U2 - 10.1183/09031936.00194311

DO - 10.1183/09031936.00194311

M3 - Journal article

C2 - 22878880

SN - 0904-1850

VL - 41

SP - 909

EP - 916

JO - Acta tuberculosea Scandinavica

JF - Acta tuberculosea Scandinavica

IS - 4

ER -