Format

Send to

Choose Destination
J Infect. 2018 Sep 26. pii: S0163-4453(18)30284-6. doi: 10.1016/j.jinf.2018.09.011. [Epub ahead of print]

Combined use of Quantiferon and HBHA-based IGRA supports tuberculosis diagnosis and therapy management in children.

Author information

1
Institute of Microbiology, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario Gemelli, Rome, Italy.
2
Institute of Pediatrics, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario Gemelli, Rome, Italy.
3
Translational Research Unit, Epidemiology and Preclinical Research Department, National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Rome, Italy.
4
Institute of Pediatrics, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario Gemelli, Rome, Italy. Electronic address: piero.valentini@unicatt.it.

Abstract

OBJECTIVES:

Interferon-γ release assays (IGRA) are designed for diagnosis of tuberculosis (TB) infection, and do not discriminate latent TB infection (LTBI) from active TB. Heparin-binding hemagglutinin antigen (HBHA) emerged as a promising antigen for TB diagnosis when used in IGRA format. Aim of this study was to prospectively evaluate the performance of an HBHA-based IGRA to support TB diagnosis and TB therapy monitoring in children with TB infection or active TB disease.

METHODS:

Following clinical, microbiological and radiological assessment, children (0-14 years old) were tested by the QuantiFERON TB-Gold In tube (QFT) assay and an aliquot of whole-blood was stimulated with HBHA and IFNγ evaluated only in QFT-positive subjects.

RESULTS:

Among the 550 children tested, 486 (88.4%) scored negative and 64 (11.6%) positive. None of the QFT-negative had active TB. Among the QFT-positive, 45 were with LTBI and 19 active TB. HBHA-IGRA scored positive in 41/45 children (91.1%) with LTBI and in 6/19 active TB children (31.6%) at diagnosis (p = 0.001); remarkably, 5 of these 6 children with active TB scoring HBHA-positive were asymptomatic. Moreover, following TB-specific therapy, most of the non-HBHA-responding children, gained an HBHA-positive response.

CONCLUSIONS:

HBHA-based IGRA is a useful support in TB diagnosis and TB-therapy monitoring in children.

KEYWORDS:

Biomarkers; Children; HBHA; IGRA; Monitoring of therapy; Quantiferon; Tuberculosis

PMID:
30267797
DOI:
10.1016/j.jinf.2018.09.011

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center