Higuchi Kazue, Kondo Shuji, Wada Masako, Hayashi Sawako, Ootsuka Gorou, Sakamoto Noboru, Harada Nobuyuki
The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City, Tokyo, Japan.
J Infect. 2009 May;58(5):352-7. doi: 10.1016/j.jinf.2009.02.019. Epub 2009 Apr 1.
To evaluate the usefulness of QuantiFERON-TB Gold (QFT-G) for children.
Students in a primary school exposed to a tuberculosis patient were investigated using the tuberculin skin test (TST), chest X-ray examination and sequential QFT-G tests.
The first QFT-G test was conducted one month after the end of exposure for 308 of the 313 children, with 6 (1.9%) positive. TST results were obtained from 306 of the students at 2 months after exposure, and 200 (65.4%) had induration > or =5mm. A second QFT-G test, a further month later, and a third QFT-G test, six months after exposure, found an additional 2 positive and one weakly positive, respectively. Overall, the rate of QFT-G positivity was 9.8% (4/41) for close contact children (> or =90h exposure), significantly higher than for casual contacts (< or =18h exposure; 1.8%, 5/272; p=0.020), whereas there was no significant difference in TST positive rates (p=0.078).
These data suggest that QFT-G has the same performance characteristics in BCG vaccinated children as it does in adults. The observation that none of the 297 students who were QFT-G negative had developed active TB after 3 years of follow-up suggests that QFT-G has a very high negative predictive value.
评估全血γ-干扰素释放试验（QFT-G）在儿童中的应用价值。
对一所小学中接触过结核病患者的学生进行结核菌素皮肤试验（TST）、胸部X线检查以及连续的QFT-G检测。
313名儿童中有308名在接触结束后1个月进行了首次QFT-G检测，其中6名（1.9%）呈阳性。在接触后2个月从306名学生处获得了TST结果，200名（65.4%）硬结≥5mm。在接触后1个月进行了第二次QFT-G检测，在接触后6个月进行了第三次QFT-G检测，分别又发现2名阳性和1名弱阳性。总体而言，密切接触儿童（接触时间≥90小时）的QFT-G阳性率为9.8%（4/41），显著高于偶然接触儿童（接触时间≤18小时；1.8%，5/272；p=0.020），而TST阳性率无显著差异（p=0.078）。
这些数据表明，QFT-G在接种卡介苗的儿童中的表现特征与在成人中相同。对297名QFT-G检测阴性的学生进行3年随访后均未发生活动性结核病的观察结果表明，QFT-G具有非常高的阴性预测价值。
