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    Apr 12, 2021
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    Systematic, Point-of-Care Urine Lipoarabinomannan (Alere TB-LAM) Assay for Diagnosing Tuberculosis in Severely Immunocompromised HIV-Positive Ambulatory Patients

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    Huerga et al 2020 Systematic ...
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    Authors
    Huerga, H
    Cossa, L
    Manhica, I
    Bastard, M
    Telnov, A
    Molfino, L
    Sanchez-Padilla, E
    Issue Date
    2020-01-20
    Submitted date
    2020-01-31
    
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    Journal
    American Journal of Tropical Medicine and Hygiene
    Abstract
    Point-of-care urine-lipoarabinomannan (LAM) Alere Determine TB-LAM assay has shown utility diagnosing tuberculosis (TB) in HIV-positive, severely immunocompromised, TB-symptomatic patients. We assessed LAM results in severely immunocompromised patients, who had LAM systematically performed at new or follow-up HIV consultations. This was a prospective, observational study on consecutive ambulatory, > 15-year-old HIV-positive patients with CD4 < 100 cells/µL in Mozambique. Clinical assessments and LAM were performed for all and microscopy, Xpert, sputum culture, and chest X-ray for LAM-positive participants. Patients were followed up for 6 months. Of 360 patients, half were ART-naive. Lipoarabinomannan positivity was 11.9% (43/360), higher among symptomatic patients compared with asymptomatic: 18.5% (30/162), and 6.6% (13/198), respectively, P = 0.001. Tuberculosis was bacteriologically confirmed in 6/35 LAM-positive patients (2 of them asymptomatic). Lipoarabinomannan positivity was associated with higher risk of mortality (aOR:4.48, 95% CI: 1.24-16.23, P = 0.022). Systematic urine-LAM allows for rapid TB treatment initiation in severely immunocompromised HIV ambulatory patients and identifies patients at a higher risk of death.
    Publisher
    American Society of Tropical Medicine and Hygiene
    URI
    http://hdl.handle.net/10144/619596
    DOI
    10.4269/ajtmh.19-0493
    PubMed ID
    31971152
    Language
    en
    ISSN
    1476-1645
    ae974a485f413a2113503eed53cd6c53
    10.4269/ajtmh.19-0493
    Scopus Count
    Collections
    TB

    entitlement

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