Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis: a multicentre PTBNET study. Issue 3 (25th October 2022)

• Record Type: Journal Article
• Authors: Buonsenso, Danilo; Noguera-Julian, Antoni; Moroni, Rossana; Hernández-Bartolomé, Angel; Fritschi, Nora; Lancella, Laura; Cursi, Laura; Soler-Garcia, Aleix; Krüger, Renate; Feiterna-Sperling, Cornelia; Sali, Michela; Lo Vecchio, Andrea; Scarano, Sara; Hernanz Lobo, Alicia; Espiau, Maria; Soriano-Arandes, Antonio; Cetin, Benhur Sirvan; Brinkmann, Folke; Ozere, Iveta; Baquero-Artigao, Fernando; Tsolia, Maria; Milheiro Silva, Tiago; Bustillo-Alonso, Matilde; Martín Nalda, Andrea; Mancini, Margherita; Starshinova, Anna; Ritz, Nicole; Velizarova, Svetlana; Ferreras-Antolín, Laura; Götzinger, Florian; Bilogortseva, Olga; Chechenyeva, Vira; Tebruegge, Marc; Santiago-García, Begoña;
• Other Names: author non-byline.; Minguell Laura author non-byline.; Peromingo Estrella author non-byline.; Pastrana David Gomez author non-byline.; Pérez-Porcuna Tomas author non-byline.; Soto Beatriz author non-byline.; Gil Elena Colino author non-byline.; Herranz-Aguirre Mercedes author non-byline.; Martin Cesar Gavilan author non-byline.; López-Medina Eva María author non-byline.; Bell Christine author non-byline.; Child Frances author non-byline.; Ivaškevičienė Inga author non-byline.; Lobato Zulema author non-byline.; Rius Neus author non-byline.; Calavia Olga author non-byline.; Blázquez-Gamero Daniel author non-byline.; Carazo Begoña author non-byline.; Campins Maria QS author non-byline.; Calvo Cristina author non-byline.; Murua Javier Korta author non-byline.; Buxbaum Charlotte author non-byline.; Pavić Ivan author non-byline.; Alvarez Cristina author non-byline.; Cobo-Vazquez Elvira author non-byline.; Gorricho Beatriz Perez author non-byline.; Rodriguez Sonia author non-byline.; Menasalvas Ana author non-byline.; Llanos Maria IG author non-byline.; Berhard-Stirnemann Sara author non-byline.; Rohr Marie author non-byline.; Relly Christa author non-byline.; Rodriguez Lourdes Garcia author non-byline.; Pozo Maria del author non-byline.; Rivero-Calle Irene author non-byline.; Tagarro Alfredo author non-byline.; Duppenthaler Andrea author non-byline.; Guignard Isabelle Rochat author non-byline.; Buettcher Michael author non-byline.; Whittaker Elizabeth author non-byline.; McMaster Paddy author non-byline.; Vigliano Verdiana author non-byline.; Russo Cristina author non-byline.;
• Is Part Of: Thorax. Volume 78:Issue 3(2023)
• Page Start: 288
• Page End: 296
• Publication Date: 2022-10-25
• Subjects: Tuberculosis; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2022-218929
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Rationale: In 2016, a new interferon-gamma release assay (IGRA) was introduced, QuantiFERON-TB Gold Plus (QFT-Plus), claimed to have improved sensitivity in active tuberculosis (TB). Objectives: This study aimed to determine the performance of QFT-Plus, compared with previous generation IGRAs and the tuberculin skin test (TST), in children with TB in Europe. Methods: Multicentre, ambispective cohort study within the Paediatric Tuberculosis Network European Trials Group (ptbnet), a dedicated paediatric TB research network comprising >300 members, capturing TB cases <18 years-of-age diagnosed between January 2009 and December 2019. Measurements and main results: 1001 TB cases from 16 countries were included (mean age (IQR) 5.6 (2.4–12.1) years). QFT-Plus was performed in 358, QFT Gold in-Tube (QFT-GIT) in 600, T-SPOT. TB in 58 and TST in 636 cases. The overall test sensitivities were: QFT-Plus 83.8% (95% CI 80.2% to 87.8%), QFT-GIT 85.5% (95% CI 82.7% to 88.3%), T-SPOT. TB 77.6% (95% CI 66.9% to 88.3%) and TST (cut-off ≥10 mm) 83.3% (95% CI 83.3% to 86.2%). There was a trend for tests to have lower sensitivity in patients with miliary and/or central nervous system (CNS) TB (73.1%, 70.9%, 63.6% and 43.5%, respectively), and in immunocompromised patients (75.0%, 59.6%, 45.5% and 59.1%, respectively). Conclusions: The results indicate that the latest generation IGRA assay, QFT-Plus, does not perform better than previous generation IGRAs or the TST in children with TB disease. Overall, tests performed worse in CNS and miliary TB, and in immunocompromised children. None of the tests evaluated had sufficiently high sensitivity to be used as a rule-out test in children with suspected TB.