Background:To evaluate the performance of theQuantiferon(R)-TB Gold In-Tube (QFT-IT) interferon (IFN)-7 assay for the detection of latent tuberculosis infection (LTBI)in children receiving anti-rheumatic treatment in a tertiary referral hospital of Northern Greece.Methods:A total of 79 consecutive children receiving anti-rheumatic treatment [of which 18 screened prior to antitumor necrosis factor (TNF)-α treatment] were tested using Mantoux tuberculin skin test (TST) and QFT-IT.Association of both tests with risk factors for latent tuberculosis and Bacillus Calmette-Guerin immunization was determined.Influence of age,TNF-α inhibitors,systemic corticosteroids,conventional disease modifying anti-rheumatic drugs (DMARDs) and total duration of therapy on the QFT-IT mitogen-induced response was evaluated.Results:Agreement between TST and QFT-IT results was moderate (k=0.38).Frequency of QFT-IT indeterminate results was low (2.5％).In patients with risk factors for LTBI,the odds of a positive IFN-7 assay was increased by a factor of 27.6 (P=0.002),whereas there was no positive TST.There was a significant difference in the mitogeninduced IFN-7 secretion among various treatments (P=0.038).TNF-α inhibitors were associated with increased mitogen-induced IFN-7 secretion compared to monotherapy with conventional DMARDs (P=0.008).All children screened prior to anti-TNF-a treatment exhibited a negative QFT-IT and no active TB disease was detected during a 2-year follow-up.Conclusions:QFT-IT may be a more reliable test than TST for detection of LTBI in children with rheumatic diseases receiving anti-rheumatic treatment.Drug regimen might influence the mitogen-induced IFN-γ secretion and the effect of TNF-α inhibitors might vary according to the specific agent administered.
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