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

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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%), T-SPOT®.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 sub-optimally in this group of children, and therefore none of them can be used in isolation to confirm or disprove TB infection.

Keywords: cancer; children; interferon-gamma release assays; lymphopaenia; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Paediatrics and Child Health, Tygerberg Children's Hospital, Tygerberg, South Africa 2: Department of Paediatrics and Child Health, Desmond Tutu TB Centre for Research and Education, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa

Publication date: June 1, 2010

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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