Skip to Main Content
TABLE 2

Suggested Uses of TST and IGRA in Children

TST preferred 
 • Children younger than 5 ya 
IGRA preferred, TST acceptable 
 • Children 5 y or older who have received BCG vaccine 
 • Children 5 y or older who are unlikely to return for the TST reading 
Both the TST and an IGRA should be considered when: 
 • The initial and repeat IGRA results are indeterminate/invalid 
 • The initial test (TST or IGRA) result is negative and: 
   • There is clinical suspicion of TB diseaseb 
   • The child has a TB risk factor and is at high risk of progression and poor outcome (especially therapy with an immunomodulating biologic agent, such as a TNF-α antagonist)b 
 • The initial TST is positive and: 
   • The patient is 5 years or older and has a history of BCG vaccination 
   • Additional evidence is needed to increase adherence with therapy 
TST preferred 
 • Children younger than 5 ya 
IGRA preferred, TST acceptable 
 • Children 5 y or older who have received BCG vaccine 
 • Children 5 y or older who are unlikely to return for the TST reading 
Both the TST and an IGRA should be considered when: 
 • The initial and repeat IGRA results are indeterminate/invalid 
 • The initial test (TST or IGRA) result is negative and: 
   • There is clinical suspicion of TB diseaseb 
   • The child has a TB risk factor and is at high risk of progression and poor outcome (especially therapy with an immunomodulating biologic agent, such as a TNF-α antagonist)b 
 • The initial TST is positive and: 
   • The patient is 5 years or older and has a history of BCG vaccination 
   • Additional evidence is needed to increase adherence with therapy 

TNF-α, tumor necrosis factor α.

a

Some experts will use an IGRA in children 2 to 4 years of age, especially if they have received a BCG vaccine but have no other significant risk factors. Most experts do not use an IGRA for children younger than 2 years because of lack of data for this age group and the high risk of progression to disease.

b

A positive result of either test is considered significant in these groups.

Close Modal

or Create an Account

Close Modal
Close Modal