2018 AAP Red Book® recommends TB blood testing for children

TB blood testing preferred by American Academy of Pediatrics in BCG-vaccinated children 2 years and older.

The AAP now recommends that modern TB blood tests (IGRAs) can be used to detect TB infection among children age 2 or older in any situation where a TST would historically be used (1). Moreover, IGRAs are the preferred test for asymptomatic children 2 years and older who have been vaccinated with BCG or are unlikely to return for skin test reading.

The new Red Book guidelines usher in a new era of IGRAs as the standard of care test for LTBI in BCG vaccinated children. Growing pediatric evidence on IGRAs continues to validate their use in increasingly younger age groups.  – Dr. Masae Kawamura, QIAGEN Medical Affairs

Watch a free webinar on pediatric TB testing with Dr. Sonia Qasba

Watch our free on-demand webinar to learn more about the rationale behind the new AAP pediatric IGRA recommendations and LTBI treatment regimens, while learning more broadly at how TB elimination efforts are increasingly focused on employing preventive methods in the primary care setting. The program will be led by Dr. Sonia Qasba, a physician at Suburban Hospital, part of Johns Hopkins Medicine. Dr. Qasba is board certified in Infectious Disease, Internal Medicine, and Pediatrics.

Want to learn more about IGRA testing for school children?

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A wave of support for IGRA testing

This important update from the AAP underscores a wave of recent guidelines that highlight the value of IGRA testing for foreign-born populations in the US – where prior BCG vaccination can contribute to inaccurate results from the TB skin test (TST). False-positive TST results in BCG-vaccinated populations burden patients and health care institutions alike, while true positive results to be improperly dismissed as a response to prior vaccination.

IGRA testing is a modern solution to detect TB infection

IGRA tests such as QuantiFERON-TB Gold Plus are a patient centered, affordable way to test for TB infection that produce more accurate results than the century-old tuberculin skin test (TST).

Testing with IGRAs is:

  • Convenient – single patient visit
  • Highly accurate and objective
  • Cost-effective
  • Covered by Medicare, Medicaid and most private insurance

The US CDC also recommends IGRAs

Closely mirroring the AAP, the US Centers for Disease Control and Prevention recommends testing for TB with IGRAs for most individuals aged 5 years or older. IGRAs are preferred by the CDC for most risk groups, including (2):

  • Those likely to be infected with TB
  • Anyone with low or intermediate risk of disease progression
  • Those for whom it has been decided that testing for latent TB infection is warranted

IGRAs are also strongly recommended in those who are also BCG-vaccinated, or unlikely to return to have their TST read.


QuantiFERON-TB Gold Plus is the best-selling IGRA test in the US. Find out more about QFT-Plus at our Provider Resources Portal


Disclaimer: The performance of the USA format of the QFT-Plus test has not been extensively evaluated with specimens from individuals younger than age 17 years.


1. American Academy of Pediatrics. Red Book®: 2018–2021 Report of the Committee on Infectious Diseases. 829-853.
2. Lewinsohn, D.M. et al. (2017) Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention.

Product claims may differ from country to country based on regulations and approvals. Contact your country representative for further details.

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