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- Title
Use of Interferon-Gamma Release Assays in Children <2 Years Old.
- Authors
Turner, Nicholas A; Ahmed, Amina; Haley, Connie A; Starke, Jeffrey R; Stout, Jason E
- Abstract
While interferon-gamma release assays (IGRAs) are widely used for detecting tuberculosis (TB) infection, tuberculin skin tests (TSTs) remain preferred for children under the age of 2 years. The preference for TST stems from concern over IGRA sensitivity in young children. However, TSTs are susceptible to false-positive results following Bacille Calmette-Guérin (BCG) vaccination, which is common in infancy, and exposure to nontuberculous mycobacteria. We reviewed available data for IGRA performance in children under age 2 years. Across four cohorts of high-risk children under age 2 (mostly case contacts or those born in tuberculosis endemic regions), 0 of 575 untreated children with negative IGRA test results progressed to tuberculosis disease—including 0 of 70 who were TST positive but IGRA negative. While neither TSTs nor IGRAs are perfectly sensitive for the diagnosis of tuberculosis infection, IGRAs are an acceptable alternative to TST in children <2 years of age.
- Subjects
TUBERCULOSIS diagnosis; INTERFERON gamma release tests; PREDICTIVE tests; TUBERCULIN test; SENSITIVITY &; specificity (Statistics); DIAGNOSTIC errors; CHILDREN
- Publication
Journal of the Pediatric Infectious Diseases Society, 2023, Vol 12, Issue 8, p481
- ISSN
2048-7193
- Publication type
Article
- DOI
10.1093/jpids/piad053