C-Reactive Protein as a Screening Test for Tuberculosis in People Living with HIV in Southern India: A Cross-Sectional, Observational Study.

Abstract

Background: Tuberculosis is the leading cause of mortality in people living with HIV(PLHIV). We assessed the utility of C-reactive protein (CRP) as a screening test for tuberculosis (TB) in PLHIV. Methods: We performed a cross-sectional, observational study on 150 HIV patients visiting the Anti-Retroviral Therapy (ART) center for the follow up of their ART treatment. Patients who screened positive on the WHO symptom screen were included in the study. C-reactive protein levels in the blood were measured, and the patients were followed up with for a confirmatory diagnosis of tuberculosis. Results: The ideal cut-off for CRP was found to be 8.25. There was a statistically significant relationship between the CRP value and tuberculosis positivity (p value < 0.001). The CRP value had a sensitivity of 70.13%, a specificity of 69.86%, a positive predictive value of 71.05%, a negative predictive value of 68.92%, and a total diagnostic accuracy of 70% in patients who screened positive on the WHO symptom screen. Conclusion: CRP is a valuable screening tool and should be added to the tuberculosis screening algorithm to improve the diagnostic accuracy of screening for tuberculosis in people living with HIV.