QuantiFERON-TB Gold Plus Test in Diagnostics of Latent Tuberculosis Infection in Children Aged 1-14 in a Country with a Low Tuberculosis Incidence

Pol J Microbiol. 2021 Dec;70(4):461-468. doi: 10.33073/pjm-2021-042. Epub 2021 Dec 23.

Abstract

The aim of the study was to evaluate the QuantiFERON-TB Gold Plus (QFT-Plus) test usability in the identification of latent tuberculosis infection (LTBI) in children and the determination of features associated with tuberculin skin test (TST) and QFT-Plus-positive results concerning LTBI. Two-hundred thirteen children aged 1-14 were screened for LTBI due to household contact with TB, suspected TB, or were qualified for biological therapy. The objective of this study was to evaluate the QFT-Plus affectivity as a diagnostic test in the absence of a gold standard (GS) test for the diagnosis of LTBI. The children were diagnosed with QFT-Plus, TST, and culture of TB. The QFT-Plus results were analyzed depending on the children's age, TST size, and type. In children aged 1-4, the positive predictive value of QFT-Plus was 1, the negative predictive value was 0.94, QFT-Plus sensitivity was 75%, and specificity was 100%. It was observed that in children aged 5-14 years, the level of agreement decreased to the substantial, i.e., 87.2%. Moreover, the negative predictive value was 0.83. QFT-Plus sensitivity was 64%, and specificity was 100%. Statistical analysis of QFT-Plus and TST results showed substantial and almost perfect agreements. Our study suggests that QFT-Plus is helpful in a pediatric practice showing good sensitivity and specificity for LTBI. The BCG vaccine, infections, and concomitant morbidities do not affect QFT-Plus results.

Keywords: QuantiFERON-TB Gold Plus; children; latent tuberculosis infection; tuberculin skin test; tuberculosis.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Humans
  • Incidence
  • Infant
  • Latent Tuberculosis* / diagnosis
  • Latent Tuberculosis* / epidemiology
  • Sensitivity and Specificity
  • Tuberculin Test / methods
  • Tuberculosis* / diagnosis
  • Tuberculosis* / epidemiology