Abstract

BackgroundTuberculosis remains a worldwide problem fueled by the HIV epidemic. TB infection impacts HIV progression and mortality even with treatment. Egypt has increasing HIV prevalence, although still in low prevalent areas.ResultsUrinary LAM was positive in 22 (95.7%) of TB patients and 1 (1.9%) of non TB group. Sensitivity was 95.7%, specificity 98.1%, positive and negative predictive values were 95.7% and 98.1% respectively, with accuracy 97.4%. Urinary LAM ELISA assay has the highest sensitivity (95.7%) in relation to other tests used for TB detection in HIV patients and its concentration was highly correlated to CD4 cell count and the extent of radiological changes.ConclusionThe use of urinary LAM in HIV patients is rapid, safe, available, and helpful tool for ruling in TB especially for those who cannot expectorate, critically ill, with low CD4, or presented by multiple system affection.

Highlights

  • Tuberculosis remains a worldwide problem fueled by the Human immunodeficiency virus (HIV) epidemic

  • Marked progress in HIV management, late presentation of cases with TB still represents a major threat to survival

  • The aim of this study was to evaluate the role of urinary LAM in diagnosis of active tuberculosis in patients with HIV in relation to different diagnostic tools to help early management for improving outcome

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Summary

Introduction

TB infection impacts HIV progression and mortality even with treatment. Mycobacterium tuberculosis infection clearly impacts HIV progression and mortality, and disease from M. tuberculosis increases in HIV-infected patients as CD4 cell counts decline [1]. The prevalence of HIV infection in Middle East and North Africa (MENA) MENA is 0.1% which is the lowest worldwide, HIV-related deaths were estimated to be 15,000 cases in 2013 which representing increase by two-thirds since 2005 [2]. Marked progress in HIV management, late presentation of cases with TB still represents a major threat to survival. The aim of this study was to evaluate the role of urinary LAM in diagnosis of active tuberculosis in patients with HIV in relation to different diagnostic tools to help early management for improving outcome

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