Interferon-gamma release assays for the detection of Mycobacterium tuberculosis infection in children with cancer

Date
2010
Authors
Stefan D.C.
Dippenaar A.
Detjen A.K.
Schaaf H.S.
Marais B.J.
Kriel B.
Loebenberg L.
Walzl G.
Hesseling A.C.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
SETTING: The paediatric oncology unit at Tygerberg Children's Hospital, South Africa. OBJECTIVES: To assess the use of the tuberculin skin test (TST) and two commercial interferon-gamma release assays (IGRAs) for the detection of Mycobacterium tuberculosis infection in children with cancer before initiating chemotherapy treatment. DESIGN: Prospective hospital-based study, including children newly diagnosed with cancer; all underwent TST and IGRA testing. RESULTS: Of the 34 children enrolled, seven (17.6%) tested positive with either test: TST (3/7, 8.8%), TSPOT®.TB (n = 6, 17.6%) and QuantiFERON®-TB Gold In-Tube (QFT-G; n = 3, 8.8%). T-SPOT.TB assay results were negative in 17 (50.0%) and indeterminate in four (11.8%) children. Six T-SPOT.TB tests could not be completed due to low cell counts (<100 000 per well), and one clotted. QFT-G results were negative in 26 (76.5%) and indeterminate in five (14.7%). CONCLUSIONS: TST and IGRAs were frequently discordant, with fewer positive results than expected. T-SPOT. TB produced more positive results, but inadequate cell counts were a particular problem. The sample size was too small to comment with confidence on test accuracy. All latent TB infection tests appear to perform subo ptimally in this group of children, and therefore none of them can be used in isolation to confirm or disprove TB infection. © 2010 The Union.
Description
Keywords
gamma interferon, isoniazid, rifampicin, acute lymphoblastic leukemia, acute myeloblastic leukemia, adolescent, antibiotic resistance, article, blood cell count, brain tumor, Burkitt lymphoma, cancer chemotherapy, child, childhood cancer, clear cell sarcoma, clinical article, clinical trial, controlled clinical trial, controlled study, cytokine release, enzyme linked immunosorbent assay, enzyme linked immunospot assay, female, gastric suction, histiocytosis, Hodgkin disease, hospital based case control study, human, immunoassay, infant, interferon gamma release assay, leukocyte count, leukocyte differential count, liver function test, lymphocyte count, lymphocytopenia, male, Mycobacterium tuberculosis, neuroblastoma, osteosarcoma, patient identification, phlebotomy, preschool child, priority journal, prospective study, protein determination, rhabdomyosarcoma, school child, single blind procedure, sputum culture, T cell lymphoma, thorax radiography, tuberculin test, tuberculosis, Adolescent, Child, Child, Preschool, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Incidence, Infant, Interferon-gamma, Latent Tuberculosis, Male, Neoplasms, Prospective Studies, Reproducibility of Results, South Africa, Time Factors
Citation
International Journal of Tuberculosis and Lung Disease
14
6