Changes in results of a skin test with recombinant TB allergen during preventive chemotherapy in children exposed to TB cases
https://doi.org/10.21518/ms2026-197
Abstract
Aim. To study the dynamics of the results of a skin test with a recombinant tuberculosis allergen (ATP) (Diaskintest®) in children from tuberculosis infection foci against the background of preventive chemotherapy.
Materials and methods. A retrospective analysis of the medical records of 153 children (aged 1 to 17 years) registered at Saratov Regional Clinical Anti- Tuberculosis Dispensary in Group IVA, who had been in contact with tuberculosis patients excreting bacteria, was conducted. ATP skin test results were assessed at baseline and after a course of preventive therapy at follow-up points: 6 months and 1 year of observation.
Results. A significant reduction in the incidence of hyperergic ATP test results after a course of preventive chemotherapy was demonstrated, from 8.5% to 1.9% (4.5-fold) at 6 months and to 2.6% (3.3-fold) at 1 year of observation. Among positive results, papule size decreased in 35% of children at 6 months and in 50% at 1 year. Test negativity was achieved in 10% of children at 6 months and 1 year of observation.
Conclusions. The obtained results demonstrate the influence of preventive chemotherapy on changes in the sensitivity of ATP skin test and, therefore, the possibility of using the test to monitor latent tuberculosis infection in children and adolescents in tuberculosis foci. Children who did not convert from positive and hyperergic tests, and whose papule size did not change significantly, require further monitoring to prevent the development of active tuberculosis.
About the Authors
T. Yu. Salina
Saratov State Medical University named V.I. Razumovsky
Russian Federation
Russian Federation
Tatiana Yu. Salina, Dr. Sci. (Med), Professor, Head of Phthisiology Department
112, Bolshaya Kazachia St., Saratov, 410012
T. I. Morozova
Saratov State Medical University named V.I. Razumovsky
Russian Federation
Russian Federation
Tatiana I. Morozova, Dr. Sci. (Med), Professor, Head of Phthisiology Department
112, Bolshaya Kazachia St., Saratov, 410012
E. N. Aleksandrova
Saratov State Medical University named V.I. Razumovsky
Russian Federation
Russian Federation
Elena N. Aleksandrova, Cand. Sci. (Med), Assistant of Phthisiology Department
112, Bolshaya Kazachia St., Saratov, 410012
A. V. Efimova
Saratov Regional Clinical Tuberculosis Dispensary
Russian Federation
Russian Federation
Anastasia V. Efimova, Phthisiologist
11, Stantsionnaya St., Saratov, 410086
References
1. Vasilyeva IА, Testov VV, Sterlikov SА. Tuberculosis situation in the years of the COVID-19 pandemic – 2020–2021. Tuberculosis and Lung Diseases. 2022;100,(3):6–12. (In Russ.) https://doi.org/10.21292/2075-1230-2022-100-3-6-12.
2. Starshinova A, Sabirova A, Kudryavtsev I, Rubinstein A, Churilov LP, Belyaeva E et al. Immunological testing and machine learning in detecting latent tuberculosis among high-risk groups (nature review). Front Med. 2026;7(12):1–17. https://doi.org/10.3389/fmed.2025.1710960.
3. Kulikova IB, Vasilyeva IA, Kazakov AV, Klevno NI, Sterlikov SA, Kucheryavaya DA et al. Tuberculosis situation in pediatric population of the Russian Federation upon the end of the COVID-19 pandemic. Tuberculossand Lung Diseases. 2025;103(3):8–16. (In Russ.) https://doi.org/10.58838/2075-1230-2025-103-3-8-16.
4. Gong W, Wu X. Differential Diagnosis of Latent Tuberculosis Infection and Active Tuberculosis: A Key to a Successful Tuberculosis Control Strategy. Front Microbiol. 2021;12:745592. https://doi.org/10.3389/fmicb.2021.745592.
5. Felker IG, Pavlenok IV, Stavitskaya NV, Kudlay DA. Latent Tuberculosis Infection Among Children and Adults in the Regions with High Prevalence of Tuberculosis. Tuberculosis and Lung Diseases. 2023;101(1):34–40. (In Russ.) https://doi.org/10.58838/2075-1230-2023-101-1-34-40.
6. Aksenova VA, Klevno NI, Kavtarashvili SM. A tuberculosis infection focus and its value in the development of tuberculosis in children. Tuberculosis and Lung Diseases. 2015;(1):19–24. (In Russ.) https://doi.org/10.21292/2075-1230-2015-0-1-19-24.
7. Myakisheva TV, Novikov VE, Usacheva NE. Evaluation of the effectiveness of preventive chemotherapy in children from tuberculosis infection foci. Tuberculosis and Socially Significant Diseases. 2021;(1):74–75. (In Russ.) Available at: https://www.elibrary.ru/vjofrw.
8. Vernon A. Treatment of latent tuberculosis infection. Semin Respir Crit Care Med. 2013;34(1):67–86. https://doi.org/10.1055/s-0032-1333544.
9. Аксенова ВА, Клевно НИ, Барышникова ЛА. Выявление и диагностика туберкулеза у детей, поступающих и обучающихся в образовательных организациях: клинические рекомендации. М.; 2017. 40 с.
10. Kudlay DA. Hybrid proteins CFP10 and ESAT6. A path from developing a molecule to population screening for TB infection. Immunologiya. 2021;42(2):166–174. (In Russ.) https://doi.org/10.33029/0206-4952-2021-42-2-166-174.
11. Slogotskaya LV, Litvinov V, Kudlay DA, Ovsyankina E, Seltsovsky P, Ivanova D, Nikolenko N. New skin test with recombinant protein CFP10-ESAT6 in patients (children and adults) with tuberculosis, non-tuberculosis disease and latent TB infection. Eur Res J (Suppl.). 2012;40(S56):416. Available at: https://elibrary.ru/zdiazn.
12. Shovkun L, Aksenova V, Kudlay D, Sarychev A. The role of immunological tests in the diagnosis of tuberculosis infection in children with juvenile idiopathic arthritis (JIA). Eur Res J (Suppl.). 2018;52(S62):PA2733. Available at: https://www.elibrary.ru/ynwzsp.
13. Slogotskaya LV, Bogorodskaya Е, Ivanova D, Makarova M, Guntupova L, Litvinov V et al. Sensitivity and specificity of new skin test with recombinant protein CFP10-ESAT6 in patients with tuberculosis and individuals with non-tuberculosis diseases. Eur Res J (Suppl.). 2013;42(S57):1995. Available at: https://www.elibrary.ru/zdlphn.
14. Vasilyeva IA, Aksenova VA, Kazakov AV, Kiseleva YY, Maryandyshev AO, Dolzhenko EN et al. Evaluation of the specificity of an intradermal test with recombinant tuberculosis allergen in bacillus Calmette-Guérin-vaccinated healthy volunteers. Front Med. 2023;10:104246. https://doi.org/10.3389/fmed.2023.1042461.
15. Aksenova VA, Vasilyev IA, Klevno NI, Kazakov AV, Doktorova NP. Validity of a negative skin test result with recombinant tuberculosis allergen in order to exclude the active tuberculosis in children. Pediatriya – Zhurnal im G.N. Speranskogo. 2022;101(4):43–49. (In Russ.) https://doi.org/10.24110/0031-403X-2022-101-4-43-49.
16. Aksenova VA, Barishnikova LA, Klevno NI, Sokolskaya EA, Dolzhenko ЕN, Shuster АM et al. New screening and diagnostic options of various traits of tb infection among children and adolescents in Russia. Current Pediatrics. 2011;10(4):16–22. (In Russ.) Available at: https://vsp.sprjournal.ru/jour/article/view/638.
17. Slogotskaya LV, Litvinov V, Ovsyankina E, Kudlay D, Seltsovsky P, Seltsovsky N, Ivanova D. Results of QuantiFERON-TB Gold in-tube and skin testing with recombinant proteins CFP-10-ESAT-6 in children and adolescents with TB or latent TB infection. Paediatr Respir Rev. 2013;14(2):S65. https://doi.org/10.1016/S1526-0542(13)70092-7.
18. Aksenova VA, Baryshnikova LA, Klevno NI, Kudlay DA. Screening for tuberculosis infection in children and adolescents in Russia – past, present, future. Tuberculosis and Lung Diseases. 2019;97(9):59–67. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-9-59-67.
19. Kuday DA. Biomarkers and immunological tests. Experimental and clinical parallels of latent tuberculosis infection. Tuberculosis and Lung Diseases. 2020;98(8):63–74. (In Russ.) https://doi.org/10.21292/2075-1230-2020-98-8-63-74.
20. Romanova МA, Mordyk АV, Kurieva KB, Churyak KI. Importance of immunodiagnostics in dynamic observation of tuberculosis treatment in children. Meditsinskiy Sovet. 2021;(11):183–187. (In Russ.) https://doi.org/10.21518/2079-701X-2021-11-183-187.
21. Litvinov VI, Shuster AM, Slogotskaya LV, Seltsovsky PP, Ovsyankina YeS, Mushkin AYu et al. Effectiveness of new diagnostic drug Diaskintest® in children for tuberculosis detection and diagnosis. Tuberculosis and Lung Diseases. 2009;4(86):19–22. (In Russ.) Available at: https://www.elibrary.ru/kxfvgj.
22. Aksenova VA, Levi DT, Aleksandrova NV, Kudlay DA, Baryshnikova LA, Klevno NI. Pediatric TB: Modern Methods for Prevention and Early Diagnostics. Doctor.Ru. 2017;144(15):9–15. (In Russ.) Available at: https://journaldoctor.ru/catalog/pediatriya/tuberkulez-u-detey/.
23. Baryshnikova ES, Plotnikova ED, Mezhebovskij VR, Mezhebovskij AV. Effectiveness of preventive chemotherapy for tuberculosis in the early period of tuberculosis infection in children. Modern Problems of Science and Education. 2019;(6):169. (In Russ.) https://doi.org/10.17513/spno.29435.
24. Zorkaltseva EYu, Pugacheva SV. Effectiveness of Preventive Anti-tuberculosis Treatment of Children in a Specialized Sanatorium and Outpatient Settings. Experience from Irkutsk Oblast. Tuberculosis and Lung Diseases. 2025;103(1):68–73. (In Russ.) https://doi.org/10.58838/2075-1230-2025-103-1-68-73.
25. Yarovaya YuA, Lozovskaya ME, Vasil’eva EB, Klochkova LV, Stepanov GA. Dynamics of expression of intradermal immunological test during anti-tb therapy in children with respiratory tuberculosis. Vestnik of Novgorod State University. Series: Medical Sciences. 2020;119(3):67–70. (In Russ.) https://doi.org/10.34680/2076-8052.2020.3(119).67-70.
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For citations:
Salina TY, Morozova TI, Aleksandrova EN, Efimova AV. Changes in results of a skin test with recombinant TB allergen during preventive chemotherapy in children exposed to TB cases. Meditsinskiy sovet = Medical Council. (In Russ.) https://doi.org/10.21518/ms2026-197
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