Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Jul 19;79(1):215-222.
doi: 10.1093/cid/ciae158.

Tuberculosis Disease in Immunocompromised Children and Adolescents: A Pediatric Tuberculosis Network European Trials Group Multicenter Case-control Study

Paula Rodríguez-Molino  1   2   3   4 , Marc Tebruegge  5   6   7 , Antoni Noguera-Julian  8   9   10 , Olaf Neth  11 , Katy Fidler  12 , Folke Brinkmann  13 , Talia Sainz  1   2   3   4 , Inga Ivaskeviciene  14 , Nicole Ritz  15   16 , Maria Joao Brito  17 , Tiago Milheiro Silva  17 , Vira Chechenieva  5   18   19 , Maryna Serdiuk  18 , Laura Lancella  20 , Cristina Russo  20 , Aleix Soler-García  8 , Maria Luisa Navarro  21   22   4 , Renate Krueger  23 , Cornelia Feiterna-Sperling  23 , Anna Starshinova  24 , Antonina Hiteva  24 , Anna Hoffmann  13 , Paulius Kalibatas  14 , Andrea Lo Vecchio  25   26 , Sara Maria Scarano  25   26 , Matilde Bustillo  27 , Daniel Blázquez Gamero  28 , María Espiau  29 , Danilo Buonsenso  30 , Lola Falcón  11 , Louise Turnbull  31 , Elena Colino  32 , Santiago Rueda  33 , Charlotte Buxbaum  34 , Begoña Carazo  35 , Cristina Alvarez  36 , Marta Dapena  37 , Anabel Piqueras  38 , Svetlana Velizarova  39 , Iveta Ozere  40 , Florian Götzinger  5 , Marta Pareja  41 , Maria Isabel Garrote Llanos  42 , Beatriz Soto  43 , Sonia Rodríguez Martín  44   45 , Jose Javier Korta  46 , Beatriz Pérez-Gorricho  47 , Mercedes Herranz  48 , Ángel Hernández-Bartolomé  21   22 , Mariana Díaz-Almirón  49 , Malte Kohns Vasconcelos  50 , Laura Ferreras-Antolín  51 , Begoña Santiago-García  21   22   4
Affiliations
Multicenter Study

Tuberculosis Disease in Immunocompromised Children and Adolescents: A Pediatric Tuberculosis Network European Trials Group Multicenter Case-control Study

Paula Rodríguez-Molino et al. Clin Infect Dis. .

Abstract

Background: In high-resource settings, the survival of children with immunocompromise (IC) has increased and immunosuppressive therapies are increasingly being used. This study aimed to determine the clinical characteristics, performance of diagnostic tools, and outcome of IC children with tuberculosis (TB) in Europe.

Methods: Multicenter, matched case-control study within the Pediatric Tuberculosis Network European Trials Group, capturing TB cases <18 years diagnosed 2000-2020.

Results: A total of 417 TB cases were included, comprising 139 children who are IC (human immunodeficiency virus, inborn errors of immunity, drug-induced immunosuppression, and other immunocompromising conditions) and 278 non-IC children as controls. Nonrespiratory TB was more frequent among cases than controls (32.4% vs 21.2%; P = .013). Patients with IC had an increased likelihood of presenting with severe disease (57.6% vs 38.5%; P < .001; odds ratio [95% confidence interval], 2.073 [1.37-3.13]). Children with IC had higher rates of false-negative tuberculin skin test (31.9% vs 6.0%; P < .001) and QuantiFERON-TB Gold assay (30.0% vs 7.3%; P < .001) results at diagnosis. Overall, the microbiological confirmation rate was similar in IC and non-IC cases (58.3% vs 49.3%; P = .083). Although the mortality in children with IC was <1%, the rate of long-term sequelae was significantly higher than in non-IC cases (14.8% vs 6.1%; P = .004).

Conclusions: Children with IC and TB in Europe have increased rates of nonrespiratory TB, severe disease, and long-term sequelae. Immune-based TB tests have poor sensitivity in those children. Future research should focus on developing improved immunological TB tests that perform better in patients with IC, and determining the reasons for the increased risk of long-term sequelae, with the aim to design preventive management strategies.

Keywords: Europe; immune-based tests; immunodeficiency; immunosuppression; tuberculosis.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest . B. S. G. and M. T. have received support from Cepheid for a project on molecular tuberculosis diagnostics unrelated to the study reported here. M. T. has received QuantiFERON-TB assays at reduced pricing or free of charge for tuberculosis diagnostics projects from Cellestis/Qiagen in the past and has received support for conference attendance from Cepheid. The manufacturers had no influence on the study design, data collection, analysis or interpretation, writing of the manuscript, or the decision to submit the data for publication. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

References

Publication types

Substances