GIÁ TRỊ XÉT NGHIỆM QUANTIFERON-TUBERCULOSIS GOLD PLUS TRONG CHẨN ĐOÁN TRẺ MẮC LAO KHÔNG BẰNG CHỨNG VI KHUẨN HỌC

Abstract

Background: QuantiFERON-TB Gold Plus (QFT-Plus), a new generation of IGRAs, is an assay based on the release of interferon-gamma (IFN-g) by lymphocytes exposed to the tuberculosis (TB) bacillus synthetase peptide. QFT-Plus is used in the diagnosis of tuberculosis, but current data is showed that QFT-Plus has been evaluated mainly in adults, but very little data in children. The TB diagnosis in children is challenging for the clinician due to the lack of symptoms and difficulty in obtaining sputum samples in children. The purpose of this study was evaluated the value of QFT-Plus in diagnosing children with TB without bacteriological confirmation. Objective: To determine diagnostic value of QFT-Plus in children pulmonary TB (PTB), extra-pulmonary TB (EPTB). Subjects and Methods: A retrospective, cross-sectional study with analysis performed on patient children to the cardiology department at Pham Ngoc Thach Hospital from 2018 to 2022. Results: 60 patients were recruited, including 26 (43,3%) men anh 34(56,7%) women. The positive rate of QFT-Plus in the group of suspected tuberculosis without bacteriological evidence (BCVKH) was 41.7%. In which, 9 patients were diagnosed with pulmonary tuberculosis and 27 patients were diagnosed with extrapulmonary tuberculosis. The sensitivity of QFT-Plus for TB overall was 66.7%, specificity was 95.8%, positive predictive value 96%, negative predictive value 65.7%. Conclusion: Through the study, the overall sensitivity and specificity of QFT-Plus for TB disease without bacteriological confirmation (were 66.7%, 95.8% and found that the incidence of extrapulmonary tb in this group of subjects was 66.7% and 95.8%. 45% and QFT-Plus sensitivity of this group is 77.7%. The increased incidence of extrapulmonary TB in this group is related to the difficulty of diagnosis and the low sensitivity of microbiological tests. QFT-Plus is not qualified to diagnose TB because our country has a high TB ​​infection rate. However, QFT-Plus will contribute a part to the diagnosis of TB in without bacteriological confirm when combined with other clinical and laboratory evaluations.