期刊
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE
卷 96, 期 1, 页码 -出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.diagmicrobio.2019.114892
关键词
Tuberculosis; Diagnostics; Urine; Xpert ultra; Lipoarabinomannan
资金
- Bill and Melinda Gates Foundation Trust through Global Good Fund at Intellectual Ventures
- Pulmonary Complications of AIDS Research Training (PART) Program (National Institutes of Health-Fogarty International Center) [D43TW009607]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development [K12 HD000850]
The performance of urine Xpert MTB/RIF Ultra (Xpert Ultra) for pulmonary TB diagnosis is unknown. HIV-positive and HIV-negative adults were enrolled at two health facilities in Kampala, Uganda. We compared the accuracy of urine Xpert Ultra and Determine TB-LAM in reference to sputum-based testing (positive Xpert MTB/RIF or culture), and assessed incremental yield. Urine Xpert Ultra had low sensitivity (17.2%, 95% CI 12.3-23.2) but high specificity (98.1%, 95% CI 94.4-99.6). Sensitivity reached 50.0% (95% CI 28.2-71.8) among HIV-positive patients with CD4 <100 cells/mu L. Compared to Determine TB-LAM, urine Xpert Ultra was 9.4% (95% CI 3.8-14.9, P = 0.01) more sensitive, and 17.2% (95% CI 4.5-29.8, P = 0.01) more sensitive among HIV-positive patients. However, the incremental sensitivity of urine Xpert Ultra relative to sputum Xpert MTB/RIF was only 1% (95% CI -0.9 to 2.8). Urine Xpert Ultra could be an alternative for patients with advanced HIV infection unable to produce sputum. (C) 2019 Elsevier Inc. All rights reserved.
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