Host, technical, and environmental factors affecting QuantiFERON-TB Gold In-Tube performance in children below 5 years of age

• Published in: Scientific reports Vol. 12; no. 1; pp. 19908 - 9
• Main Authors: Velasco-Arnaiz, Eneritz, Batllori, Marta, Monsonís, Manuel, Valls, Anna, Ríos-Barnes, María, Simó-Nebot, Sílvia, Gamell, Anna, Fortuny, Clàudia, Tebruegge, Marc, Noguera-Julian, Antoni
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 19-11-2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/250; 631/250/255; Acute-Phase Reaction; Age; Antigens; C-reactive protein; Child; Child, Preschool; Children; Cotinine; Cross-Sectional Studies; Environmental factors; Erythrocyte sedimentation rate; Gold; Humanities and Social Sciences; Humans; Interferon-gamma Release Tests - methods; Latent Tuberculosis - diagnosis; multidisciplinary; Multivariate analysis; Science; Science (multidisciplinary); Seasons; Tuberculosis; Tuberculosis - diagnosis; γ-Interferon
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-24433-w

Interferon-gamma release assays performance can be impaired by host-related, technical and environmental factors, but data in young children are limited. We performed a cross-sectional study of children < 5 years-of-age at risk of tuberculosis (TB), using QuantiFERON-TB Gold In-Tube (QFT-GIT) assays. The impact of the following was evaluated: (i) host-related [age; hematological parameters; erythrocyte sedimentation rate (ESR); C-reactive protein (CRP); and tobacco smoke exposure (TSE) based on serum cotinine concentrations], (ii) technical (pre-analytical delay) and (iii) environmental factors (annual season; monthly temperatures). Of 204 children, 35 (17.2%) were diagnosed with latent TB infection or TB disease. QFT-GIT results were indeterminate in 14 (6.9%) patients. In multivariate analysis, younger age and higher ESR were associated with lower positive control responses (beta: 0.247,
p
 = 0.002 and − 0.204,
p
 = 0.007, respectively), and increasing age was associated with lower rates of indeterminate QFT-GIT results [OR (95% CI) 0.948 (0.903–0.996) per month,
p
 = 0.035]. In children with positive QFT-GIT results, average monthly temperatures correlated with antigen responses (r = 0.453,
p
 = 0.020); also, antigen responses were lower in winter than in other seasons (
p
 = 0.027). Serum cotinine concentrations determined in a subgroup of patients (n = 41) indicated TSE in 36 (88%), positive control responses being lower in children with TSE (
p
 = 0.034). In children < 5 years-of-age, young age, elevated ESR, temperature, annual season and TSE can affect the performance of QFT-GIT assays.