Can Interferon-Gamma Release Assays Replace Tuberculin Skin Test in Children?

Identifying young children at risk for tuberculosis is challenging. The tuberculin skin test (TST) lacks specificity due to cross-reactivity with other mycobacteria, including those in the BCG vaccine. Although interferon-gamma release assays (IGRAs) are more specific and have replaced TST in most settings, their performance has not been well studied in children, particularly young children, who are at risk for more-rapid progression from latent tuberculosis infection (LTBI) to disease.

Researchers prospectively followed nearly 3600 children in 11 states (92% foreign born; 25% <5 years old) who were at risk for LTBI or progression to tuberculosis and underwent testing with TST and two IGRAs, QuantiFERON-TB Gold In-Tube test (QFT-GIT) and T-S…