Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country ...Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.展开更多
Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HI...Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes>25%or>500 cells/mm3 for at least 6 months.QuantiF ERON-TB Gold,T-SPOT.TB,and tuberculin skin test were performed in each patient.Results:A total of 50 patients were enrolled with median age of 13.7 years,CD4 counts of 753(IQR:587-989)cells/mm3.Among 27 patients with tuberculosis(16)or tuberculosis exposure(11),8(29.6%)were positive to at least one test,2(7.4%)were positive QuantiFERON-TB Gold,3(11.1%)positive T-SPOT.TB,and 7(25.9%)had tuberculin skin test≥5 mm.Among 23 patients without history of tuberculosis or exposure,all had negative interferon gamma release assays,while 2(8.7%)had positive tuberculin skin test.Conclusions:All tests had low sensitivity despite immune reconstitution.展开更多
Background：Interferon-gamma release assay （IGRA） has been used in latent tuberculosis （TB） infection and TB diagnosis,but the results from different high TB-endemic countries are different.The aim of this study w...Background：Interferon-gamma release assay （IGRA） has been used in latent tuberculosis （TB） infection and TB diagnosis,but the results from different high TB-endemic countries are different.The aim of this study was to investigate the value of IGRA in the diagnosis of active pulmonary TB （PTB） in China.Methods：We conducted a large-scale retrospective multicenter investigation to further evaluate the role of IGRA in the diagnosis of active PTB in high TB-epidemic populations and the factors affecting the performance of the assay.All patients who underwent valid T-SPOT.TB assays from December 2012 to November 2015 in six large-scale specialized TB hospitals in China and met the study criteria were retrospectively evaluated.Patients were divided into three groups：Group 1,sputum culture-positive PTB patients,confirmed by positive Mycobacterium tuberculosis sputum culture;Group 2,sputum culture-negative PTB patients;and Group 3,non-TB respiratory diseases.The medical records of all patients were collected.Chi-square tests and Fisher＇s exact test were used to compare categorical data.Multivariable logistic analyses were performed to evaluate the relationship between the results of T-SPOT in TB patients and other factors.Results：A total of 3082 patients for whom complete information was available were included in the investigation,including 905 sputum culture-positive PTB cases,914 sputum cultmre-negative PTB cases,and 1263 non-TB respiratory disease cases.The positive rate of T-SPOT.TB was 93.3% in the culture-positive PTB group and 86.1% in the culture-negative PTB group.In the non-PTB group,the positive rate of T-SPOT.TB was 43.6%.The positive rate of T-SPOT.TB in the culture-positive PTB group was significantly higher than that in the culture-negative PTB group （x2 =25.118,P 〈 0.01）,which in turn was significantly higher than that in the non-TB group （x2 =566.l 16,P 〈 0.01）.The overall results were as follows：sensitivity,89.7%;specificity,56.37%;positive predictive value,74.75%;negative predictive value,79.11%;and accuracy,76.02%.Conclusions：High false-positive rates of T-SPOT.TB assays in the non-TB group limit the usefulness as a single test to diagnose active TB in China.We highly recommend that IGRAs not be used for the diagnosis of active TB in high-burden TB settings.展开更多
目的评价γ-干扰素释放试验(interferon-gamma release assay,IGRA)在结核病专科门诊诊断儿童活动性结核病的效能。方法回顾性分析2019年1月至2021年12月就诊于西安市胸科医院结核病门诊的268例疑似结核病患儿为研究对象,采用area under...目的评价γ-干扰素释放试验(interferon-gamma release assay,IGRA)在结核病专科门诊诊断儿童活动性结核病的效能。方法回顾性分析2019年1月至2021年12月就诊于西安市胸科医院结核病门诊的268例疑似结核病患儿为研究对象,采用area under the ROC curve(AUC)评估在不同年龄阶段,有无卡痕,有无结核病密切接触史患儿中IGRA诊断活动性结核病的效能。结果在结核病专科门诊,IGRA诊断儿童活动性结核的敏感度、特异度、阴性预测值、阳性预测值、AUC分别为80.6%、63.6%、48.6%、88.5%、0.74。IGRA诊断儿童结核病AUC(95%CI值),在年龄≤5岁患儿中为0.71(0.62~0.80),低于6~14岁组的0.75(0.70~0.81),两组差异无统计学意义(Z=-0.848,P=0.40);在可见卡痕患儿中为0.72(0.67~0.78),与未见卡痕组的0.72(0.61~0.83)无统计学差异(Z=0.067,P=0.946);在有密接史组为0.83(0.75~0.91),高于无密接史组的0.72(0.66~0.77),两组差异有统计学意义(Z=2.336,P=0.020)。IGRA联合TST诊断儿童结核病AUC(95%CI值)为0.79(0.74~0.83),与TST单独诊断结核病AUC无统计学差异(Z=1.598,P=0.110)。结论在结核病专科门诊γ-干扰素释放试验诊断儿童活动性结核病准确度一般,在无结核病接触史患儿中其准确度较低,结核病专科门诊使用IGRA诊断儿童活动性结核病时需考虑其密切接触史情况。展开更多
文摘Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.
基金supported by the Faculty of Medicine Siriraj Hospital,Mahidol University,Bangkok,Thailand,[Grant Number(IO)R015832028].Oxford Immunotec and Biomed diagnostics(Thailand)provided the T-SPOT.TB test kit
文摘Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes>25%or>500 cells/mm3 for at least 6 months.QuantiF ERON-TB Gold,T-SPOT.TB,and tuberculin skin test were performed in each patient.Results:A total of 50 patients were enrolled with median age of 13.7 years,CD4 counts of 753(IQR:587-989)cells/mm3.Among 27 patients with tuberculosis(16)or tuberculosis exposure(11),8(29.6%)were positive to at least one test,2(7.4%)were positive QuantiFERON-TB Gold,3(11.1%)positive T-SPOT.TB,and 7(25.9%)had tuberculin skin test≥5 mm.Among 23 patients without history of tuberculosis or exposure,all had negative interferon gamma release assays,while 2(8.7%)had positive tuberculin skin test.Conclusions:All tests had low sensitivity despite immune reconstitution.
文摘Background：Interferon-gamma release assay （IGRA） has been used in latent tuberculosis （TB） infection and TB diagnosis,but the results from different high TB-endemic countries are different.The aim of this study was to investigate the value of IGRA in the diagnosis of active pulmonary TB （PTB） in China.Methods：We conducted a large-scale retrospective multicenter investigation to further evaluate the role of IGRA in the diagnosis of active PTB in high TB-epidemic populations and the factors affecting the performance of the assay.All patients who underwent valid T-SPOT.TB assays from December 2012 to November 2015 in six large-scale specialized TB hospitals in China and met the study criteria were retrospectively evaluated.Patients were divided into three groups：Group 1,sputum culture-positive PTB patients,confirmed by positive Mycobacterium tuberculosis sputum culture;Group 2,sputum culture-negative PTB patients;and Group 3,non-TB respiratory diseases.The medical records of all patients were collected.Chi-square tests and Fisher＇s exact test were used to compare categorical data.Multivariable logistic analyses were performed to evaluate the relationship between the results of T-SPOT in TB patients and other factors.Results：A total of 3082 patients for whom complete information was available were included in the investigation,including 905 sputum culture-positive PTB cases,914 sputum cultmre-negative PTB cases,and 1263 non-TB respiratory disease cases.The positive rate of T-SPOT.TB was 93.3% in the culture-positive PTB group and 86.1% in the culture-negative PTB group.In the non-PTB group,the positive rate of T-SPOT.TB was 43.6%.The positive rate of T-SPOT.TB in the culture-positive PTB group was significantly higher than that in the culture-negative PTB group （x2 =25.118,P 〈 0.01）,which in turn was significantly higher than that in the non-TB group （x2 =566.l 16,P 〈 0.01）.The overall results were as follows：sensitivity,89.7%;specificity,56.37%;positive predictive value,74.75%;negative predictive value,79.11%;and accuracy,76.02%.Conclusions：High false-positive rates of T-SPOT.TB assays in the non-TB group limit the usefulness as a single test to diagnose active TB in China.We highly recommend that IGRAs not be used for the diagnosis of active TB in high-burden TB settings.
文摘目的评价γ-干扰素释放试验(interferon-gamma release assay,IGRA)在结核病专科门诊诊断儿童活动性结核病的效能。方法回顾性分析2019年1月至2021年12月就诊于西安市胸科医院结核病门诊的268例疑似结核病患儿为研究对象,采用area under the ROC curve(AUC)评估在不同年龄阶段,有无卡痕,有无结核病密切接触史患儿中IGRA诊断活动性结核病的效能。结果在结核病专科门诊,IGRA诊断儿童活动性结核的敏感度、特异度、阴性预测值、阳性预测值、AUC分别为80.6%、63.6%、48.6%、88.5%、0.74。IGRA诊断儿童结核病AUC(95%CI值),在年龄≤5岁患儿中为0.71(0.62~0.80),低于6~14岁组的0.75(0.70~0.81),两组差异无统计学意义(Z=-0.848,P=0.40);在可见卡痕患儿中为0.72(0.67~0.78),与未见卡痕组的0.72(0.61~0.83)无统计学差异(Z=0.067,P=0.946);在有密接史组为0.83(0.75~0.91),高于无密接史组的0.72(0.66~0.77),两组差异有统计学意义(Z=2.336,P=0.020)。IGRA联合TST诊断儿童结核病AUC(95%CI值)为0.79(0.74~0.83),与TST单独诊断结核病AUC无统计学差异(Z=1.598,P=0.110)。结论在结核病专科门诊γ-干扰素释放试验诊断儿童活动性结核病准确度一般,在无结核病接触史患儿中其准确度较低,结核病专科门诊使用IGRA诊断儿童活动性结核病时需考虑其密切接触史情况。
