دورية أكاديمية
Rapid urine-based screening tests increase the yield of same-day tuberculosis diagnoses among patients living with advanced HIV disease.
العنوان: | Rapid urine-based screening tests increase the yield of same-day tuberculosis diagnoses among patients living with advanced HIV disease. |
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المؤلفون: | Wake RM; Institute for Infection and Immunity, St George's University of London.; Clinical Academic Group in Infection and Immunity, St George's University Hospital NHS Foundation Trust, London, UK.; Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses (CHARM), National Institute for Communicable Diseases, a Division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa., Govender NP; Institute for Infection and Immunity, St George's University of London.; Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses (CHARM), National Institute for Communicable Diseases, a Division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa.; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.; Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand.; Division of Medical Microbiology, University of Cape Town, Cape Town., Omar SV; Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand.; Department of Medical Microbiology, University of Pretoria, Pretoria.; Centre for Tuberculosis., Ismail F; Department of Medical Microbiology, University of Pretoria, Pretoria.; Centre for Tuberculosis., Tiemessen CT; Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand.; Centre for HIV & STIs, National Institute for Communicable Diseases, a Division of the NHLS, Johannesburg, South Africa., Harrison TS; Institute for Infection and Immunity, St George's University of London.; Clinical Academic Group in Infection and Immunity, St George's University Hospital NHS Foundation Trust, London, UK.; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK., Jarvis JN; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.; Botswana Harvard AIDS Institute Partnership, Gabarone, Botswana. |
المصدر: | AIDS (London, England) [AIDS] 2022 May 01; Vol. 36 (6), pp. 839-844. Date of Electronic Publication: 2022 Jan 24. |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 8710219 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-5571 (Electronic) Linking ISSN: 02699370 NLM ISO Abbreviation: AIDS Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 1998- : London, England : Lippincott Williams & Wilkins Original Publication: London : Gower Academic Journals, c1987- |
مواضيع طبية MeSH: | HIV Infections*/epidemiology , Mycobacterium tuberculosis* , Tuberculosis*/diagnosis , Tuberculosis, Pulmonary*/complications , Tuberculosis, Pulmonary*/diagnosis, Cross-Sectional Studies ; Humans ; Lipopolysaccharides ; Sensitivity and Specificity ; South Africa/epidemiology ; Sputum |
مستخلص: | Objective: Investigation of the diagnostic yield of urine-based tuberculosis (TB) screening in patients with advanced HIV disease. Design: A cross-sectional screening study. Setting: HIV outpatient clinics and wards at two hospitals in Johannesburg, South Africa, between June 2015 and October 2017. Participants: Two hundred and one patients living with advanced HIV disease (CD4+ T-lymphocytes <100 cells/μl) attending healthcare facilities following cryptococcal antigen (CrAg) screening. Intervention: Screening for TB using sputum for microscopy, culture, and Xpert MTB/Rif and urine for lipoarabinomannan (LAM) and Xpert Ultra. Main Outcome Measures: Proportion of positive results using each testing modality, sensitivity, and specificity of urine-based testing compared with culture, and survival outcomes during 6 months follow up. Results: Urine was obtained from 177 of 181 (98%) participants and sputum from 91 (50%). Urine-based screening increased same-day diagnostic yield from 7 (4%) to 31 (17%). A positive urine test with either LAM or Xpert Ultra had 100% sensitivity (95% confidence interval, 59-100%) for detecting culture-positive TB at any site. Patients with newly diagnosed TB on urine-based screening were initiated on treatment and did not have excess mortality compared with the remainder of the cohort. Conclusion: Urine is an easily obtainable sample with utility for detecting TB in patients with advanced HIV disease. Combining urine and sputum-based screening in this population facilitates additional same-day TB diagnoses and early treatment initiation, potentially reducing the risk of TB-related mortality. Urine-based as well as sputum-based screening for TB should be integrated with CrAg screening in patients living with advanced HIV disease. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.) |
References: | WHO. Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy . Geneva: World Health Organisation; 2017. Mfinanga S, Chanda D, Kivuyo SL, Guinness L, Bottomley C, Simms V, et al. Cryptococcal meningitis screening and community-based early adherence support in people with advanced HIV infection starting antiretroviral therapy in Tanzania and Zambia: an open-label, randomised controlled trial . Lancet 2015; 385:2173–2182. Letang E, Muller MC, Ntamatungiro AJ, Kimera N, Faini D, Furrer H, et al. Cryptococcal antigenemia in immunocompromised human immunodeficiency virus patients in rural Tanzania: a preventable cause of early mortality . Open Forum Infect Dis 2015; 2:ofv046. Boulware DR, Rolfes MA, Rajasingham R, von Hohenberg M, Qin Z, Taseera K, et al. Multisite validation of cryptococcal antigen lateral flow assay and quantification by laser thermal contrast . Emerg Infect Dis 2014; 20:45–53. Hansen J, Slechta ES, Gates-Hollingsworth MA, Neary B, Barker AP, Bauman S, et al. Large-scale evaluation of the immunomycologics lateral flow and enzyme-linked immunoassays for detection of cryptococcal antigen in serum and cerebrospinal fluid . Clin Vaccine Immunol 2013; 20:52–55. Jarvis JN, Percival A, Bauman S, Pelfrey J, Meintjes G, Williams GN, et al. Evaluation of a novel point-of-care cryptococcal antigen test on serum, plasma, and urine from patients with HIV-associated cryptococcal meningitis . Clin Infect Dis 2011; 53:1019–1023. WHO operational handbook on tuberculosis Module 3: Diagnosis: rapid diagnostics for tuberculosis detection. https://www.who.int/publications-detail-redirect/who-operational-handbook-on-tuberculosis-module-3-diagnosis—rapid-diagnostics-for-tuberculosis-detection . [Accessed 3 June 2021]. Lawn SD, Kerkhoff AD, Burton R, Schutz C, van Wyk G, Vogt M, et al. Rapid microbiological screening for tuberculosis in HIV-positive patients on the first day of acute hospital admission by systematic testing of urine samples using Xpert MTB/RIF: a prospective cohort in South Africa . BMC Med 2015; 13:192. Peter JG, Theron G, Muchinga TE, Govender U, Dheda K. The diagnostic accuracy of urine-based Xpert MTB/RIF in HIV-infected hospitalized patients who are smear-negative or sputum scarce . PLoS One 2012; 7:e39966. Lawn SD, Kerkhoff AD, Vogt M, Wood R. High diagnostic yield of tuberculosis from screening urine samples from HIV-infected patients with advanced immunodeficiency using the Xpert MTB/RIF assay . J Acquir Immune Defic Syndr 2012; 60:289–294. Lawn SD, Kerkhoff AD, Vogt M, Wood R. Diagnostic accuracy of a low-cost, urine antigen, point-of-care screening assay for HIV-associated pulmonary tuberculosis before antiretroviral therapy: a descriptive study . Lancet Infect Dis 2012; 12:201–209. Peter JG, Theron G, van Zyl-Smit R, Haripersad A, Mottay L, Kraus S, et al. Diagnostic accuracy of a urine lipoarabinomannan strip-test for TB detection in HIV-infected hospitalised patients . Eur Respir J 2012; 40:1211–1220. Singhroy DN, MacLean E, Kohli M, Lessem E, Branigan D, England K, et al. Adoption and uptake of the lateral flow urine LAM test in countries with high tuberculosis and HIV/AIDS burden: current landscape and barriers . Gates Open Res 2020; 4:24. Cazabon D, Suresh A, Oghor C, Qin ZZ, Kik SV, Denkinger CM, et al. Implementation of Xpert MTB/RIF in 22 high tuberculosis burden countries: are we making progress? . Eur Respir J 2017; 50:1700918. Wake RM, Govender NP, Omar T, Nel C, Mazanderani AH, Karat AS, et al. Cryptococcal-related mortality despite fluconazole preemptive treatment in a cryptococcal antigen screen-and-treat program . Clin Infect Dis 2019; 70:1683–1690. Manabe YC, Nonyane BAS, Nakiyingi L, Mbabazi O, Lubega G, Shah M, et al. Point-of-care lateral flow assays for tuberculosis and cryptococcal antigenuria predict death in HIV infected adults in Uganda . PLoS One 2014; 9:e101459. Liechty CA, Solberg P, Were W, Ekwaru JP, Ransom RL, Weidle PJ, et al. Asymptomatic serum cryptococcal antigenemia and early mortality during antiretroviral therapy in rural Uganda . Trop Med Int Health 2007; 12:929–935. World Health Organization. The use of lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis and screening of active tuberculosis in people living with HIV . Geneva: WHO; 2015. Lawn SD, Gupta-Wright A. Detection of lipoarabinomannan (LAM) in urine is indicative of disseminated TB with renal involvement in patients living with HIV and advanced immunodeficiency: evidence and implications . Trans R Soc Trop Med Hyg 2016; 110:180–185. Lawn SD. Point-of-care detection of lipoarabinomannan (LAM) in urine for diagnosis of HIV-associated tuberculosis: a state of the art review . BMC Infect Dis 2012; 12:103. Gupta-Wright A, Corbett EL, van Oosterhout JJ, Wilson D, Grint D, Alufandika-Moyo M, et al. Rapid urine-based screening for tuberculosis in HIV-positive patients admitted to hospital in Africa (STAMP): a pragmatic, multicentre, parallel-group, double-blind, randomised controlled trial . Lancet 2018; 392:292–301. Broger T, Sossen B, du Toit E, Kerkhoff AD, Schutz C, Ivanova Reipold E, et al. Novel lipoarabinomannan point-of-care tuberculosis test for people with HIV: a diagnostic accuracy study . Lancet Infect Dis 2019; 19:852–861. Nicol MP, Schumacher SG, Workman L, Broger T, Baard C, Prins M, et al. Accuracy of a novel urine test, Fujifilm SILVAMP tuberculosis lipoarabinomannan, for the diagnosis of pulmonary tuberculosis in children . Clin Infect Dis 2020; 72:e280–e288. Kerkhoff AD, Sossen B, Schutz C, Reipold EI, Trollip A, Moreau E, et al. Diagnostic sensitivity of SILVAMP MTB-LAM (FujiLAM) point-of-care urine assay for extra-pulmonary tuberculosis in people living with HIV . Eur Respir J 2020; 55:1901259. Nel JS, Lippincott CK, Berhanu R, Spencer DC, Sanne IM, Ive P. Does disseminated nontuberculous mycobacterial disease cause false-positive determine B-LAM lateral flow assay results? A retrospective review . Clin Infect Dis 2017; 65:1226–1228. Horne DJ, Kohli M, Zifodya JS, Schiller I, Dendukuri N, Tollefson D, et al. Xpert MTB/RIF and Xpert MTB/RIF Ultra for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Infectious Diseases Group, editor . Cochrane Database Syst Rev 2019; 6:1465–1858. Opota O, Zakham F, Mazza-Stalder J, Nicod L, Greub G, Jaton K. Added Value of Xpert MTB/RIF Ultra for diagnosis of pulmonary tuberculosis in a low-prevalence setting. Land GA, editor . J Clin Microbiol 2018; 57:e01717–e01718. Bahr NC, Nuwagira E, Evans EE, Cresswell FV, Bystrom PV, Byamukama A, et al. Diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous meningitis in HIV-infected adults: a prospective cohort study . Lancet Infect Dis 2018; 18:68–75. Huerga H, Mathabire Rucker SC, Cossa L, Bastard M, Amoros I, Manhiça I, et al. Diagnostic value of the urine lipoarabinomannan assay in HIV-positive, ambulatory patients with CD4 below 200 cells/μl in 2 low-resource settings: a prospective observational study. Denkinger CM, editor . PLoS Med 2019; 16:e1002792. |
معلومات مُعتمدة: | MR/V033417/1 United Kingdom MRC_ Medical Research Council; R01 AI118511 United States AI NIAID NIH HHS; RP-2017-08-ST2-012 United Kingdom DH_ Department of Health |
المشرفين على المادة: | 0 (Lipopolysaccharides) |
تواريخ الأحداث: | Date Created: 20220125 Date Completed: 20220505 Latest Revision: 20240511 |
رمز التحديث: | 20240511 |
DOI: | 10.1097/QAD.0000000000003177 |
PMID: | 35075041 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1473-5571 |
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DOI: | 10.1097/QAD.0000000000003177 |