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Comparison of a whole blood Interferon-γ assay and A tuberculin skin test for detecting latent tuberculosis infection in children

Korean Journal of Pediatrics 2008;51(9):971-976.
Published online September 15, 2008.
Comparison of a whole blood Interferon-γ assay and A tuberculin skin test for detecting latent tuberculosis infection in children
Jin-Kyong Chun1, Jin-Kyong Chun1, Chang Ki Kim2, Chang Ki Kim2, Hyun Sook Kim2, Hyun Sook Kim2, Ghee Young Jung3, Ghee Young Jung3, John A. Linton3, John A. Linton4, Ki Hwan Kim1, Ki Hwan Kim1, Taek Jin Lee1, Taek Jin Lee1, Ji Hyun Jeon1, Ji Hyun Jeon1, Dong Soo Kim1, Dong Soo Kim1
1Department of Pediatrics, College of Medicine, Yonsei University, Seoul, South Korea
1Department of Pediatrics, College of Medicine, Yonsei University, Seoul, South Korea
2Department of Laboratory Medicine, College of Medicine, Yonsei University, Seoul, South Korea
2Department of Laboratory Medicine, College of Medicine, Yonsei University, Seoul, South Korea
3Department of Family Medicine, College of Medicine, Yonsei University, Seoul, South Korea
3Department of Family Medicine, College of Medicine, Yonsei University, Seoul, South Korea
4Sowha Childrens Hospital, Seoul, South Korea
소아 잠복 결핵 감염 진단에 있어서 투베르쿨린 피부반응 검사와 결핵 특이항원 자극 Interferon-γ 분비능 측정의 비교
전진경1, 전진경1, 김창기2, 김창기2, 김현숙2, 김현숙2, 정귀영3, 정귀영3, 인요한3, 인요한4, 김기환1, 김기환1, 이택진1, 이택진1, 전지현1, 전지현1, 김동수1, 김동수1
1연세대학교 의과대학 소아과학교실
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 진단검사의학교실
2연세대학교 의과대학 진단검사의학교실
3연세대학교 의과대학 가정의학교실
3연세대학교 의과대학 가정의학교실
4소화아동병원
Correspondence: 
Dong Soo Kim, Email: dskim6634@yuhs.ac
Dong Soo Kim, Email: dskim6634@yuhs.ac
Abstract
Purpose
: Surveillance for detecting and managing latent tuberculosis infection (LTBI) is a key component of tuberculosis control. The classic surveillance tool, the tuberculin skin test (TST), may have some limitations when used in the Bacillus Calmette-Guérin (BCG)-vaccinated population. The object was to perform a blood test QuantiFERON®-TB Gold In Tube (QFT-G IT) based on the detection of interferon-γ (IFN-γ) released by T cells in response to Mycobacterium tuberculosis-specific antigens, and to compare the efficacy of this new diagnostic tool for LTBI with that of TST.
Methods
: For six months, between October 1, 2006 and April 30, 2007, data were collected from 111 patients under 15 years of age at Severance Children`s Hospital. TST and QFT-G IT tests were performed with children with or without contact histories of tuberculosis. In addition to these tests, we examined comparative data from 29 adults who had tuberculosis, to detect false negative rates in the QFT-G IT method.
Results
: Thirty-three children had household contact histories. In this group, 15% and 42% of cases were found to be positive using the QFT-G IT assay and TST, respectively. Agreement was low between these two tests (κ=0.39). In the adult active tuberculosis group, the QFT-G IT false negative rate defined as a positive culture and a negative QFT-G IT result was 12.5%.
Conclusion
: In diagnosing LTBI in children, the usefulness of a whole-blood IFN-γ assay employing TB-specific antigens will be revealed only by examining additional longitudinal clinical data; this study serves as a starting point in that process.
Key Words: Children, Tuberculin skin test, Interferon-gamma release assay


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