Screening for pulmonary tuberculosis in HIV-infected individuals: AIDS Clinical Trials Group Protocol A5253

dc.creatorSwindells, S.
dc.creatorKomarow, L.
dc.creatorTripathy, S.
dc.creatorCain, K. P.
dc.creatorMacGregor, R. R.
dc.creatorAchkar, J. M.
dc.creatorGupta, A.
dc.creatorVeloso, Valdiléa G.
dc.creatorAsmelash, A.
dc.creatorOmoz-Oarhe, A. E
dc.creatorGengiah, S.
dc.creatorLalloo, U.
dc.creatorAllen, R.
dc.creatorShiboski, C.
dc.creatorAndersen, J.
dc.creatorQasba, S. S.
dc.creatorKatzenstein, D. K.
dc.creatorAIDS Clinical Trials Group 5253 Study Team
dc.date2018-11-05T16:50:59Z
dc.date2018-11-05T16:50:59Z
dc.date2013
dc.date.accessioned2023-09-27T00:15:17Z
dc.date.available2023-09-27T00:15:17Z
dc.identifierSWINDELLS, S. et al. Screening for pulmonary tuberculosis in HIV-infected individuals: AIDS Clinical Trials Group Protocol A5253. International Journal of Tuberculosis and Lung Disease, v. 17, n. 4, p. 532-539, 2013.
dc.identifier1027-3719
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/29853
dc.identifier10.5588/ijtld.12.0737
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8898998
dc.descriptionBACKGROUND: Improved tuberculosis (TB) screening is urgently needed for human immunodeficiency virus (HIV) infected patients. METHODS: An observational, multi-country, cross-sectional study of HIV-infected patients to compare a standardized diagnostic evaluation (SDE) for TB with standard of care (SOC). SOC evaluations included TB symptom review (current cough, fever, night sweats and/or weight loss), sputum Ziehl-Neelsen staining and chest radiography. SDE screening added extended clinical signs and symptoms and fluorescent microscopy (FM). All participants underwent all evaluations. Mycobacterium tuberculosis on sputum culture was the primary outcome. RESULTS: A total of 801 participants were enrolled from Botswana, Malawi, South Africa, Zimbabwe, India, Peru and Brazil. The median age was 33 years; 37% were male, and median CD4 count was 275 cells/mm(3). Thirty-one participants (4%) had a positive culture on Löwenstein-Jensen media and 54 (8%) on MGIT. All but one positive culture came from sub-Saharan Africa, where the prevalence of TB was 54/445 (12%). SOC screening had 54% sensitivity (95%CI 40-67) and 76% specificity (95%CI 72-80). Positive and negative predictive values were respectively 24% and 92%. No elements of the SDE improved the predictive values of SOC. CONCLUSIONS: Symptom-based screening with smear microscopy was insufficiently sensitive. More sensitive diagnostic testing is required for HIV-infected patients.
dc.formatapplication/pdf
dc.languageeng
dc.rightsopen access
dc.subjectTuberculosis
dc.subjectDiagnostics
dc.subjectHIV infection
dc.subjectSensitivity
dc.subjectSpecificity
dc.titleScreening for pulmonary tuberculosis in HIV-infected individuals: AIDS Clinical Trials Group Protocol A5253
dc.typeArticle


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