The Pediatric infectious disease journal 2017 09 05() doi 10.1097/INF.0000000000001774
Data regarding the use of QuantiFERON to assist the diagnosis of active tuberculosis (TB) in HIV-infected children is limited, especially in countries with low incidence of TB/HIV co-infection.
QuantiFERON results were analyzed in 63 HIV-infected children who presented to our hospital in Paris, France. Seventeen HIV-uninfected children with active TB (4 culture-confirmed) were included for comparison.
The 63 HIV-infected children (median age: 11 years) had 113 QuantiFERON tests. Thirty-four (54%) were born in sub-Saharan Africa. Vertical HIV transmission was documented for 50/52 (96%) and stage III HIV-infection for 30/50 children (60%).Over the study period, active TB was diagnosed in 7/63 HIV-infected children (3 culture-confirmed). Additional ongoing or previous opportunistic infections were present in 4/7.QuantiFERON results were positive in 2/7 HIV-infected children with active TB (sensitivity: 29%) and 16/17 HIV-uninfected children with active TB (sensitivity 94%).At initial QuantiFERON testing of the 63 HIV-infected children, 8 (13%) had positive results (1, active TB; 5, latent TB; 2, previous TB) and 51 (81%) had negative results. Of 33 children with repeat testing after an initially positive or negative result, the only change was one conversion from a negative to a positive result at the onset of active TB.The four children (6%) with indeterminate quantiFERON results had a concomitant opportunistic infection, Results of repeat testing after clinical stabilization was negative in all four.
QuantiFERON testing performed poorly for active TB diagnosis in this series of children with advanced HIV infection.