QuantiFERON-TB Gold Plus Performance in Children: A Narrative Review

This review summarizes studies evaluating the performance of the QuantiFERON-TB Gold Plus (QFT-Plus) interferon-gamma release assay (IGRA) test for Mycobacterium tuberculosis (Mtb) infection in children. Literature searching was conducted using PubMed, MEDLINE and Embase (January 2017 to December 2021) and the terms children or pediatric and IGRAs or QuantiFERON-TB Gold Plus. Selected studies (N = 14; 4646 subjects) enrolled children with Mtb infection, tuberculosis (TB) disease or healthy children with household TB contacts. Agreement between QFT-Plus and tuberculin skin test (TST) (kappa values) ranged from -0.201 (no agreement) to 0.83 (almost perfect agreement). Assay sensitivity of QFT-Plus (against reference standard of microbiologically confirmed TB disease) was 54.5%-87.3%, with no reported difference in children less than 5 versus greater than or equal to 5 years of age. In individuals less than or equal to 18 years of age, the rate of indeterminate results was 0%-33.3% (2.6% in children <2 years). IGRAs may overcome the limitations of TST in young, Bacillus Calmette-Guerin-vaccinated children.

Automated summary

This review summarizes studies on the performance of the QuantiFERON-TB Gold Plus (QFT-Plus) interferon-gamma release assay (IGRA) for Mycobacterium tuberculosis (Mtb) infection in children. The agreement between QFT-Plus and tuberculin skin test (TST) varied from no agreement to almost perfect agreement. The sensitivity of QFT-Plus in detecting microbiologically confirmed TB disease ranged from 54.5% to 87.3%, with no difference based on age.