Stavri Henriette, Ene Luminiţa, Popa Gabriela Loredana, Duiculescu Dan, Murgoci Gheorghe, Marica Constantin, Ulea Irina, Cus Gabriela, Popa Mircea Ioan
Cantacuzino National Research and Development Institute for Microbiology and Immunology, Mycobacterial Antigens Department, Bucharest, Romania.
Roum Arch Microbiol Immunol. 2009 Jan-Mar;68(1):14-9.
We compared the usefulness of three methods designed to diagnose latent tuberculosis [TB]: interferon-gamma release assay [IGRA], such as QuantiFERON-TB Gold [QFT-G], Enzyme-linked immunosorbent assay [ELISA] serologic assay and tuberculin skin test [TST] for diagnosis of TB in human immunodeficiency virus [HIV]-1 infected children and adolescents, with microbiologically and/or histopathologically confirmed TB co-infection. The serum samples were obtained from 36 patients who were examined and tested by the three methods. The sensitivity was 38.8% for TST, 47.2% for IGRA (QFT-G) and 11.1% for ELISA. Out of 24 patients with severe immune suppression (CD4+ < 200 cells/ml), 6 had positive TST, i.e. sensitivity 25%, 10 positive QFT-G results, i.e. sensitivity 41.6%. 6 of the QFT-G results could not been determined. ELISA was positive only for one of them. Among the 12 patients without severe immune suppression (CD4+ > 200 cells/ml), 8 had positive TST, QFT-G was positive in 7 patients., 3 of QFT-G results could not been determined. ELISA was positive in 3/12 patients. Only 3 of these results were simultaneously positive with TST, QFT-G and ELISA. Our results demonstrated concordance between QFT-G and TST in HIV-infected children and adolescents diagnosed with TB. Since all the patients had active TB, it was not possible to calculate the specificity of the tests. ELISA had the lowest sensitivity, while QFT-G and TST sensitivities were comparable for the children and adolescents with CD4+ count >200 cells/ml. Further research is needed in HIV-1 positive children and adolescents with and without TB in order to validate rapid diagnosis methods for TB.
我们比较了三种用于诊断潜伏性结核病（TB）的方法的有效性：干扰素-γ释放测定法（IGRA），如QuantiFERON-TB Gold（QFT-G）、酶联免疫吸附测定法（ELISA）血清学检测和结核菌素皮肤试验（TST），用于诊断合并微生物学和/或组织病理学确诊的TB共感染的人类免疫缺陷病毒（HIV）-1感染儿童和青少年。血清样本取自36名接受这三种方法检测的患者。TST的敏感性为38.8%，IGRA（QFT-G）为47.2%，ELISA为11.1%。在24例严重免疫抑制（CD4+<200细胞/毫升）的患者中，6例TST呈阳性，即敏感性为25%，10例QFT-G结果呈阳性，即敏感性为41.6%。6例QFT-G结果无法确定。ELISA仅对其中1例呈阳性。在12例无严重免疫抑制（CD4+>200细胞/毫升）的患者中，8例TST呈阳性，7例患者QFT-G呈阳性，3例QFT-G结果无法确定。ELISA在12例患者中有3例呈阳性。这些结果中只有3例同时TST、QFT-G和ELISA呈阳性。我们的结果表明，在诊断为TB的HIV感染儿童和青少年中，QFT-G和TST之间具有一致性。由于所有患者均患有活动性TB，因此无法计算这些检测的特异性。ELISA的敏感性最低，而对于CD4+计数>200细胞/毫升的儿童和青少年，QFT-G和TST的敏感性相当。对于有和没有TB的HIV-1阳性儿童和青少年，需要进一步研究以验证TB的快速诊断方法。
