Interferon-γ release assays for the diagnosis of Mycobacterium tuberculosis infection in children: a systematic review and meta-analysis

Data regarding the use of Interferon-gamma release assays (IGRAs) for tuberculosis diagnosis are accumulating. We systematically searched PubMed, EMBASE and Cochrane and performed pooled estimates of sensitivity and specificity of QuantiFERON-TB Gold In Tube (QFT-G-IT) and T-SPOT. TB compared to tuberculin skin test (TST). For studies assessing sensitivity, children had to have active tuberculosis. Specificity data were derived from children classified as non-infected. Eleven studies were included in the sensitivity analysis for TST, 10 for QFT-G-IT, and 9 for T-SPOT.TB. Eight studies were included in specificity analysis for TST, 8 for QFT-G-IT, and 7 for T-SPOT.TB. Pooled QFT-G-IT sensitivity was 0.79 (95%CI:0.70–0.89) pooled T-SPOT.TB sensitivity was 0.74 (95%CI:0.59–0.90) and pooled TST sensitivity was 0.82 (95%CI:0.72–0.93). Pooled QFT-G-IT and T-SPOT.TB specificities were 0.95 (95%CI:0.93–0.97) and 0.96 (95%CI:0.93–1.00), respectively. Pooled TST specificity was significantly lower 0.83 (95%CI:0.74–0.92). IGRA performance in children showed no better sensitivity than TST, but higher specificity.