The Magnitude of Interferon Gamma Release Assay Responses in Children With Household Tuberculosis Contact is Associated With Tuberculosis Exposure and Disease Status

Details

• Alternative Title:
  Pediatr Infect Dis J
• Personal Author:
  Ronge, Lena ; Sloot, Rosa ; Preez, Karen Du ; Kay, Alexander W. ; Lester Kirchner, H. ; Grewal, Harleen M. S. ; Mandalakas, Anna M. ; Hesseling, Anneke C.
• Description:
  Background
  
  The clinical utility of the magnitude of interferon gamma (IFNγ) in response to mycobacterial antigens is unknown. We assessed the association between quantitative IFNγ response and degree of M. tuberculosis exposure, infection and tuberculosis (TB) disease status in children.
  
  Methods
  
  We completed cross-sectional analysis of children (≤15 years) exposed to an adult with bacteriologically confirmed TB, 2007–2012 in Cape Town, South Africa. IFNγ values were reported as concentrations and spot forming units (SFU) for the QuantiFERON-TB Gold In-Tube (QFT-GIT), and T-SPOT.TB, respectively. Random effects linear regression was used to investigate the relation between the M. tuberculosis contact score, clinical phenotype (TB diseased, infected, uninfected) and IFNγ response as outcome, adjusted for relevant covariates.
  
  Results
  
  We analyzed data from 669 children (median age 63 months; IQR=33–108). A one-unit increase in M. tuberculosis contact score was associated with an increase of IFNγ 0.60 IU/ml (95%CI=0.44–0.76), and IFNγ SFU 2 counts (95%CI=1–3). IFNγ response was significantly lower among children with M. tuberculosis infection compared to children with TB disease (β =−1.42, 95%CI=−2.80- −0.03) for the QFT-GIT, but not for the T-SPOT.TB. This association was strongest among children 2–5 years (β =−2.35, 95%CI=−4.28- −0.42) and absent if <2 years.
  
  Discussion
  
  The magnitude of IFNγ response correlated with the degree of recent M. tuberculosis exposure, measured by QFT-GIT and T-SPOT.TB, and was correlated with clinically relevant TB phenotypes, using the QFT-GIT. IFNγ values are not only useful in estimating the risk of M. tuberculosis infection but may also support the diagnosis of TB disease in children.
  
  
• Subjects:
  Adolescent Antigens, Bacterial Child Child, Preschool Cross-Sectional Studies Family Characteristics Humans Infant Interferon-gamma Release Tests Male Mycobacterium Tuberculosis Predictive Value Of Tests South Africa Tuberculin Test Tuberculosis

  More +
• Keywords:
  Children Diagnosis IFNγ Magnitude Tuberculosis
• Source:
  Pediatr Infect Dis J. 40(8):763-770
• Pubmed ID:
  34050092
• Pubmed Central ID:
  PMC8277676
• Document Type:
  Journal Article
• Funding:
  R01 AI137527/AI/NIAID NIH HHSUnited States/ ; K01 TW011482/TW/FIC NIH HHSUnited States/ ; U01GH002278/ACL/ACL HHSUnited States/ ; UM1 AI069521/AI/NIAID NIH HHSUnited States/ ; U01 GH002278/GH/CGH CDC HHSUnited States/ ; R01 AI076199/AI/NIAID NIH HHSUnited States/ ; K43 TW011006/TW/FIC NIH HHSUnited States/
• Volume:
  40
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:574a6e36388e1df4a1d240c39263d47d5fd867668657893c841b0a948a41aad0
• Download URL:
  https://stacks.cdc.gov/view/cdc/158050/cdc_158050_DS1.pdf
• File Type:
  [PDF - 734.77 KB ]