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dc.contributor.authorHuerga, H
dc.contributor.authorCossa, L
dc.contributor.authorManhica, I
dc.contributor.authorBastard, M
dc.contributor.authorTelnov, A
dc.contributor.authorMolfino, L
dc.contributor.authorSanchez-Padilla, Elisabeth
dc.date.accessioned2021-01-23T16:29:35Z
dc.date.available2021-01-23T16:29:35Z
dc.date.issued2020-01-20
dc.date.submitted2021-01-18
dc.identifier.urihttp://hdl.handle.net/10144/619825
dc.description.abstractPoint-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 (adjusted odds ratio [aOR]: 4.6, 95% CI: 1.3–15.6, P = 0.015). Systematic urine-LAM allows for rapid TB treatment initiation in severely immunocompromised HIV ambulatory patients and identifies patients at a higher risk of death.en_US
dc.language.isoenen_US
dc.publisherAmerican Society of Tropical Medicine and Hygieneen_US
dc.rightsWith thanks to the American Society of Tropical Medicine and Hygiene.en_US
dc.titleSystematic, Point-of-Care Urine Lipoarabinomannan (Alere TB-LAM) Assay for Diagnosing Tuberculosis in Severely Immunocompromised HIV-Positive Ambulatory Patientsen_US
dc.identifier.journalAmerican Journal of Tropical Medicine and Hygieneen_US
refterms.dateFOA2021-01-23T16:29:36Z


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