Abstract
The utility of the adenosine deaminase (ADA) assay in the diagnosis of patients with pleural tuberculosis (TB) and human immunodeficiency virus (HIV) infection is controversial. Forty-eight HIV positive patients with pleural effusion were evaluated; ADA assay was obtained in forty-three of them. Twenty-five patients presented diagnosis of TB. Patients with diagnosis of TB showed a median value of ADA of 70 IU/L (interquartile range (IQR) 41–89) and the non-TB group a median of 27.5 IU/L (IQR 13.5–52). Patients with diagnosis of TB had a median cluster of differentiation 4 (CD4) count of 174 (IQR 86–274) and the non-TB group had a median of 134 (IQR 71–371). Receiver operating characteristic curve was performed with an area under the curve of 0.79. The best cut-off obtained was 35 IU/L with a sensibility of 80% and a specificity of 66%. There was no correlation between CD4 lymphocytes count and the value of ADA in the TB patient group.
Highlights
There is a high incidence of patients with human immunodeficiency virus (HIV) and Mycobacterium tuberculosis co-infection
We aimed to evaluate the usefulness of the adenosine deaminase (ADA) assay in the diagnosis of pleural TB in HIV-infected patients and the usefulness of correlating this value with the cluster of differentiation 4 (CD4) lymphocyte serum count
We retrospectively reviewed all patients with concomitant presentation of pleural effusion and HIV infection who underwent a diagnostic thoracentesis and ADA level determination in pleural fluid at Hospital Nacional Prof
Summary
There is a high incidence of patients with human immunodeficiency virus (HIV) and Mycobacterium tuberculosis co-infection. Out of the 10.4 million people that were diagnosed with tuberculosis (TB) in 2016, 1.4 million (13.4%) were HIV-positive [1]. In 2016, about 0.4 million people died from tuberculosis associated with HIV. Approximately 40% of the deaths recorded in the HIV-positive patients were due to tuberculosis [1]. Pleural TB is the most common cause of extrapulmonary TB [2]. Extrapulmonary TB is more common in HIV-positive patients when compared with HIV seronegative patients [3]
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