Importance of immunodiagnostics in dynamic observation of tuberculosis treatment in children

The use of recombinant tuberculosis allergen (ATR) expands the possibilities of detecting tuberculosis. Nevertheless, the issue of the predictive value of the ATR test for assessing the result of tuberculosis therapy remains insufficiently studied.

Purpose. Тo clarify the information content of changes in the results of a test with a recombinant tuberculosis allergen against the background of chemotherapy for tuberculosis in children.

Materials and methods. We used the data of patients with active tuberculosis aged 0 to 14 years who were hospitalized. The main group in the study (1^st) included 280 children with a pronounced reaction to ATR, the comparison group (2^nd) consisted of 42 children with a moderate, mild and doubtful reaction to ATP at the time of tuberculosis detection.

Results. After 6 months from the beginning of the intensive phase of tuberculosis treatment, a hyperergic reaction to the administration of ATR was diagnosed in 74 (38.7%) children of the 1^st group and 4 (16.7%) children of the 2nd group (p = 0.025). A twofold decrease in the sample size was observed in children of the 1st group (121 children – 63.4%) than the 2^nd (7 children – 29.2%) (χ² = 8.97, p = 0.003; OR = 4.198; 95% CI 1.66–10.62). The increase in the sample is 2.9 times higher in children of the 2nd group (44 children – 23%) than in children of the 1st (χ² = 20.17, p = 0.000).

Conclusions. The extinction of sensitivity to the ATR test after specific therapy is 2 times higher in children who initially had a pronounced reaction. In the same group, a hyperergic reaction to the sample often persists or occurs after the intensive phase of anti-tuberculosis therapy.

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