TY - JOUR
T1 - Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis
T2 - a multicentre PTBNET study
AU - Buonsenso, Danilo
AU - Noguera-Julian, Antoni
AU - Moroni, Rossana
AU - Hernández-Bartolomé, Angel
AU - Fritschi, Nora
AU - Lancella, Laura
AU - Cursi, Laura
AU - Soler-Garcia, Aleix
AU - Krüger, Renate
AU - Feiterna-Sperling, Cornelia
AU - Sali, Michela
AU - Lo Vecchio, Andrea
AU - Scarano, Sara
AU - Hernanz Lobo, Alicia
AU - Espiau, Maria
AU - Soriano-Arandes, Antonio
AU - Cetin, Benhur Sirvan
AU - Brinkmann, Folke
AU - Ozere, Iveta
AU - Baquero-Artigao, Fernando
AU - Tsolia, Maria
AU - Milheiro Silva, Tiago
AU - Bustillo-Alonso, Matilde
AU - Martín Nalda, Andrea
AU - Mancini, Margherita
AU - Starshinova, Anna
AU - Ritz, Nicole
AU - Velizarova, Svetlana
AU - Ferreras-Antolín, Laura
AU - Götzinger, Florian
AU - Bilogortseva, Olga
AU - Chechenyeva, Vira
AU - Tebruegge, Marc
AU - Santiago-García, Begoña
AU - PTBNET QFT-Plus Study group
N1 - Funding Information:
HL-A is funded by the Spanish Ministry of Science and Innovation-Instituto de Salud Carlos III (ISCIII) and Fondos FEDER through the Rı́o Hortega Program (CM20/00128).HL-A is funded by the Spanish Ministry of Science and Innovation-Instituto de Salud Carlos III (ISCIII) and Fondos FEDER through the Rı́o Hortega Program (CM20/00128).
Funding Information:
AN-J was supported by "Subvencions per a la Intensificació de Facultatius Especialistes" (Departament de Salut de la Generalitat de Catalunya, Programa PERIS 2016-2020) [SLT008/18/00193]. AHL is funded by the Spanish Ministry of Science and Innovation-Instituto de Salud Carlos III and Fondos FEDER (Contrato Río Hortega CM20/00128).
Publisher Copyright:
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/3
Y1 - 2023/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85142517761&partnerID=8YFLogxK
U2 - 10.1136/thorax-2022-218929
DO - 10.1136/thorax-2022-218929
M3 - Article
C2 - 36283826
SN - 0040-6376
VL - 78
SP - 288
EP - 296
JO - Thorax
JF - Thorax
IS - 3
M1 - 218929
ER -