Cory Primaturia, Lelani Reniarti, Heda M N Nataprawira
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Therefore, the aim of this study was to assess the test agreement between QFT-Plus and the TST in LTBI detection among immunocompromised children.</p><p><strong>Method: </strong>In this cross-sectional study, we enrolled immunocompromised paediatric patients, aged between 5 and 18 years, who were treated with corticosteroids and/or chemotherapy from June to November 2019. We categorized them into three groups based on the following diseases: hematologic malignancies and nephrological and immunological diseases. We recorded the patient characteristics and QFT-Plus and TST results, in which the positive result of the TST was induration ≥ 5 mm. Within the same group, comparisons between the two tests were performed using the McNemar test, and results were statistically significant for <i>p</i> values of <0.05. The kappa index was used to assess the agreement between the two test results.</p><p><strong>Results: </strong>Among 71 patients (median age: 11.8 years) who underwent TST and QFT-Plus testing, 52% were females, and 69% had a normal nutritional status. Chemotherapy was the most common treatment modality for hematologic malignancy compared to other immunosuppressive treatments. The total number of patients with positive QFT-Plus and TST results was 11/71 (15.5%) and 4/71 (5.6%), respectively, among whom 3/11 patients had positive results in both tests, and one patient with positive TST results exhibited a discrepancy, as this was not followed by positive QFT-Plus results. QFT-Plus generated more positive results than the TST in immunocompromised children (McNemar, <i>p</i> = 0.039 (<i>p</i> < 0.05)). The diagnostic agreement between the tests was fair (<i>K</i> = 0.345, 95% CI: 0.05-0.745).</p><p><strong>Conclusion: </strong>QFT-Plus detected LTBI more effectively than the TST in immunocompromised children.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2020-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7159485","citationCount":"9","resultStr":"{\"title\":\"Comparison between the Interferon <i>γ</i> Release Assay-QuantiFERON Gold Plus (QFT-Plus)-and Tuberculin Skin Test (TST) in the Detection of Tuberculosis Infection in Immunocompromised Children.\",\"authors\":\"Cory Primaturia, Lelani Reniarti, Heda M N Nataprawira\",\"doi\":\"10.1155/2020/7159485\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Immunocompromised patients are at a higher risk of having latent tuberculosis infection (LTBI). QuantiFERON-TB Gold Plus (QFT-Plus) has been proven to perform effectively in LTBI detection among immunocompromised adults and can overcome the limitations of the tuberculin skin test (TST). However, the role of QFT-Plus in detecting LTBI in immunocompromised paediatric patients has not been well established. Therefore, the aim of this study was to assess the test agreement between QFT-Plus and the TST in LTBI detection among immunocompromised children.</p><p><strong>Method: </strong>In this cross-sectional study, we enrolled immunocompromised paediatric patients, aged between 5 and 18 years, who were treated with corticosteroids and/or chemotherapy from June to November 2019. We categorized them into three groups based on the following diseases: hematologic malignancies and nephrological and immunological diseases. We recorded the patient characteristics and QFT-Plus and TST results, in which the positive result of the TST was induration ≥ 5 mm. Within the same group, comparisons between the two tests were performed using the McNemar test, and results were statistically significant for <i>p</i> values of <0.05. The kappa index was used to assess the agreement between the two test results.</p><p><strong>Results: </strong>Among 71 patients (median age: 11.8 years) who underwent TST and QFT-Plus testing, 52% were females, and 69% had a normal nutritional status. Chemotherapy was the most common treatment modality for hematologic malignancy compared to other immunosuppressive treatments. The total number of patients with positive QFT-Plus and TST results was 11/71 (15.5%) and 4/71 (5.6%), respectively, among whom 3/11 patients had positive results in both tests, and one patient with positive TST results exhibited a discrepancy, as this was not followed by positive QFT-Plus results. QFT-Plus generated more positive results than the TST in immunocompromised children (McNemar, <i>p</i> = 0.039 (<i>p</i> < 0.05)). 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引用次数: 9
摘要
背景:免疫功能低下的患者发生潜伏性结核感染(LTBI)的风险较高。QuantiFERON-TB Gold Plus (QFT-Plus)已被证明在免疫功能低下的成年人中有效检测LTBI，并且可以克服结核菌素皮肤试验(TST)的局限性。然而，QFT-Plus在检测免疫功能低下的儿科患者LTBI中的作用尚未得到很好的证实。因此，本研究的目的是评估QFT-Plus和TST在免疫功能低下儿童LTBI检测中的一致性。方法:在这项横断面研究中，我们招募了免疫功能低下的儿童患者，年龄在5至18岁之间，于2019年6月至11月接受皮质类固醇和/或化疗治疗。我们根据以下疾病将他们分为三组:血液恶性肿瘤、肾脏和免疫疾病。记录患者特征及QFT-Plus和TST结果，其中TST阳性结果为硬结≥5 mm。在同一组中，使用McNemar检验对两种检测进行比较，结果的p值具有统计学意义:在接受TST和QFT-Plus检测的71例患者(中位年龄:11.8岁)中，52%为女性，69%营养状况正常。与其他免疫抑制治疗相比，化疗是血液病恶性肿瘤最常见的治疗方式。QFT-Plus和TST结果阳性的患者总数分别为11/71(15.5%)和4/71(5.6%)，其中3/11患者两项检测结果均为阳性，其中1例TST结果阳性的患者存在差异，因为随后没有出现QFT-Plus结果阳性。免疫功能低下儿童QFT-Plus阳性结果高于TST (McNemar, p = 0.039 (p < 0.05))。试验之间的诊断一致性是公平的(K = 0.345, 95% CI: 0.05-0.745)。结论:在免疫功能低下儿童中，QFT-Plus检测LTBI比TST更有效。
Comparison between the Interferon γ Release Assay-QuantiFERON Gold Plus (QFT-Plus)-and Tuberculin Skin Test (TST) in the Detection of Tuberculosis Infection in Immunocompromised Children.
Background: Immunocompromised patients are at a higher risk of having latent tuberculosis infection (LTBI). QuantiFERON-TB Gold Plus (QFT-Plus) has been proven to perform effectively in LTBI detection among immunocompromised adults and can overcome the limitations of the tuberculin skin test (TST). However, the role of QFT-Plus in detecting LTBI in immunocompromised paediatric patients has not been well established. Therefore, the aim of this study was to assess the test agreement between QFT-Plus and the TST in LTBI detection among immunocompromised children.
Method: In this cross-sectional study, we enrolled immunocompromised paediatric patients, aged between 5 and 18 years, who were treated with corticosteroids and/or chemotherapy from June to November 2019. We categorized them into three groups based on the following diseases: hematologic malignancies and nephrological and immunological diseases. We recorded the patient characteristics and QFT-Plus and TST results, in which the positive result of the TST was induration ≥ 5 mm. Within the same group, comparisons between the two tests were performed using the McNemar test, and results were statistically significant for p values of <0.05. The kappa index was used to assess the agreement between the two test results.
Results: Among 71 patients (median age: 11.8 years) who underwent TST and QFT-Plus testing, 52% were females, and 69% had a normal nutritional status. Chemotherapy was the most common treatment modality for hematologic malignancy compared to other immunosuppressive treatments. The total number of patients with positive QFT-Plus and TST results was 11/71 (15.5%) and 4/71 (5.6%), respectively, among whom 3/11 patients had positive results in both tests, and one patient with positive TST results exhibited a discrepancy, as this was not followed by positive QFT-Plus results. QFT-Plus generated more positive results than the TST in immunocompromised children (McNemar, p = 0.039 (p < 0.05)). The diagnostic agreement between the tests was fair (K = 0.345, 95% CI: 0.05-0.745).
Conclusion: QFT-Plus detected LTBI more effectively than the TST in immunocompromised children.
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