All issues > Volume 51(9); 2008

Original Article

Korean J Pediatr. 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 JK Chun¹, Jin-Kyong JK Chun¹, Chang Ki CK Kim², Chang Ki CK Kim², Hyun Sook HS Kim², Hyun Sook HS Kim², Ghee Young GY Jung³, Ghee Young GY Jung³, John A. JA Linton³, John A. JA Linton⁴, Ki Hwan KH Kim¹, Ki Hwan KH Kim¹, Taek Jin TJ Lee¹, Taek Jin TJ Lee¹, Ji Hyun JH Jeon¹, Ji Hyun JH Jeon¹, Dong Soo DS Kim¹, Dong Soo DS 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

Correspondence Dong Soo DS Kim ,Email: dskim6634@yuhs.ac
Dong Soo DS 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.

Keywords :Children, Tuberculin skin test, Interferon-gamma release assay