Abstract
BackgroundDevelopment of T-cells based-Interferon gamma (IFNγ) assays has offered new possibilities for the diagnosis of latent tuberculosis infection (LTBI) and active disease in adults. Few studies have been performed in children, none in France. With reference to the published data on childhood TB epidemiology in the Paris and Ile de France Region, we considered it important to evaluate the performance of IGRA (QuantiFERON TB Gold In Tube®, QF-TB-IT) in the diagnosis and the follow-up through treatment of LTBI and active TB in a cohort of French children.Methodology/Principal Findings131 children were recruited during a prospective and multicentre study (October 2005 and May 2007; Ethical Committee St Louis Hospital, Paris, study number 2005/32). Children were sampled at day 0, 10, 30, 60 (except Healthy Contacts, HC) and 90 for LTBI and HC, and a further day 120, and day 180 for active TB children. Median age was 7.4 years, with 91% of the children BCG vaccinated. LTBI and active TB children undergoing therapy produced significant higher IFNγ values after 10 days of treatment (p = 0.035). In addition, IFNγ values were significantly lower at the end of treatment compared to IFNγ values at day 0, although the number of positive patients was not significantly different between day 0 and end of treatment.Conclusions/ SignificanceBy following quantitative IFNγ values in each enrolled child with LTBI or active TB and receiving treatment, we were able to detect an increase in the IFNγ response at day 10 of treatment which might allow the confirmation of a diagnosis. In addition, a decline in IFNγ values during treatment makes it possible for clinicians to monitor the effect of preventive or curative therapy.
Highlights
Mycobacterium tuberculosis (MTB) still represents one of the most important killers among infectious pathogens. 9.2 million new tuberculosis (TB) cases in the world were reported in 2006 giving a total prevalence of 14.2 million of cases when previously diagnosed and cases undergoing treatment are included [1]
Taking advantage of the ease of use with QF-TB-IT usage, and with reference to the published data on childhood TB epidemiology in the Paris and Ile de France Region, we considered it important to evaluate the performance of Interferon-gamma release assays (IGRA) in the diagnosis of latent tuberculosis infection (LTBI) and active TB in a French children cohort in one of the highest TB incidence area in France
October 2005 and May 2007, involving 5 hospitals located in Paris and North of Ile de France Region to evaluate the intrinsic performance of IGRA in a French children cohort with latent TB infection or active TB disease, and to monitor the IFNc responses in these children, receiving antituberculous prophylaxis or therapy
Summary
Mycobacterium tuberculosis (MTB) still represents one of the most important killers among infectious pathogens. 9.2 million new tuberculosis (TB) cases in the world were reported in 2006 giving a total prevalence of 14.2 million of cases when previously diagnosed and cases undergoing treatment are included [1]. Clinicians must rely on clinical criteria, the patient history, chest radiography and tuberculin skin testing (TST) None of these approaches is totally accurate, often leading to over diagnosis of TB in children who might be unnecessarily treated for TB. Taking advantage of the ease of use with QF-TB-IT usage, and with reference to the published data on childhood TB epidemiology in the Paris and Ile de France Region, we considered it important to evaluate the performance of IGRA in the diagnosis of LTBI and active TB in a French children cohort in one of the highest TB incidence area in France. Results presented in this study allowed us to provide a comprehensive follow-up data on IFNc response during treatment for latent TB infection and active TB disease in children
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