IGRA tests perform similarly to TST but cause no adverse reactions: pediatric experience in FinlandReport as inadecuate




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BMC Research Notes

, 2:9

First Online: 15 January 2009Received: 25 November 2008Accepted: 15 January 2009DOI: 10.1186-1756-0500-2-9

Cite this article as: Tavast, E., Salo, E., Seppälä, I. et al. BMC Res Notes 2009 2: 9. doi:10.1186-1756-0500-2-9

Abstract

BackgroundTwo commercial interferon gamma release assays IGRAs QuantiFERON-TB Gold in Tube and T SPOT-TB to detect a contact with M. tuberculosis have recently become available. The majority of studies agree that the sensitivity and specificity of these methods are superior to the Tuberculin Skin Tests TSTs in detecting an exposure to bacteria in latently infected individuals and in clinical tuberculosis. However, the data in children remains limited.

FindingsConsecutively collected samples from children n = 99 representing age range from zero to 18 years were analyzed in a retrospective non-blinded study. The two IGRAs were modified and adapted to the needs of Finland, a country of a low tuberculosis incidence. For 27 children, both tests were performed simultaneously and compared with the TST and clinician-s diagnosis. The sensitivity, specificity, and accuracy of both IGRAs was determined. QuantiFERON TB Gold and T SPOT-TB performed respectively as follows: sensitivities 0.92 95% confidence interval, CI, 0.67–0.99 and 0.85 0.64–0.95; specificities 0.91 0.77–0.97 and 1.00 0.93–1.00; accuracies 0.91 0.80–0.97 and 0.96 0.88–0.99. This compares favorably to the TST whose known figures are 0.90, 0.95, and 0.95, respectively. The agreement between the IGRAs was high, k = 0.89. Finally, both methods agreed well with the TST, k = 0.86 for TST-QuantiFERON-TB Gold and k = 0.76 for TST-T SPOT-TB.

ConclusionThe sensitivity and specificity of IGRA methods compares well with the TST without the inconveniences and complications associated with TST, including exaggerated delayed type hypersensitivity reactions. These properties place them as acceptable substitutes for TST.

AbbreviationsTSTsTuberculin Skin Tests

TUTuberculin Unit

IGRAInterferon Gamma Release Assays

TBTuberculosis

LTBILatent Tuberculosis Infection

BCGBacille Calmette-Guérin

SOPStandard Operation procedure

Positive PPV and NPVNegative Predictive Values

CIConfidence Intervals

PAProportions of Agreement

ELISPOTEnzyme-linked Immunosorbent Spot Assay

Ly-TbSpotModified T-SPOT.TB

ELISAEnzyme-linked Immunosorbent Assay

QFGTQuantiFeronGold in Tube

B-TbIFNγModified QFGT

NKNatural Killer cells

PHAPhytohemagglutinin

PPDPurified Protein Derivative

HIVHuman Immunodeficiency Virus.

Electronic supplementary materialThe online version of this article doi:10.1186-1756-0500-2-9 contains supplementary material, which is available to authorized users.

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Author: Esko Tavast - Eeva Salo - Ilkka Seppälä - Tamara Tuuminen

Source: https://link.springer.com/







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