HK J Paediatr (New Series)
Vol 14. No. 2,
2009
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HK J Paediatr (New Series) 2009;14:86-95
Original Article
Interferon-gamma Release Assays in Childhood Tuberculosis: A Systematic Review
KC Chang, ECC Leung, CC Leung TB and Chest Service, Centre for Health Protection, Department of Health, Hong Kong, China KC Chang (鄭國釗) MSc, MBBS ECC Leung (梁中正) MBBS CC Leung (梁子超) MBBS Correspondence to: Dr CC Leung Received November 14, 2008
Abstract Objective and methods: To evaluate interferon-gamma release assays (IGRA) in childhood tuberculosis, a systematic review was conducted by searching MEDLINE. Results: Seventeen relevant articles were included, all using surrogate measures (positive rate in culture-confirmed tuberculosis and negative rate among low-risk subjects) for tuberculosis infection. Only one paper contained data for estimating likelihood ratios for the tuberculin skin test (TST) and IGRA among predominantly BCG-unvaccinated paediatric subjects. The positive and negative likelihood ratios (95% confidence interval) were, respectively, 5.5 (2.3-13.2) and 0.44 (0.28-0.71) for TST with 15 mm cut-off; 74.9 (4.8-1181) and 0.09 (0.03-0.29) for QuantiFERON-TB Gold in-Tube; and 37.1 (5.3-258) and 0.07 (0.02-0.28) for T-SPOT.TB tests. Predictive values varied in different clinical and epidemiological settings. Unlike TST, test performance of IGRA was not affected by BCG vaccination status. Conclusion: TST may still play an important role in targeted contact investigation and clinical management, although IGRA may outperform TST in some settings. Keyword : Child; Interferon-gamma; review; Tuberculin test; Tuberculosis Abstract in Chinese
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