| Author | Swindells, S. | |
| Author | Komarow, L. | |
| Author | Tripathy, S. | |
| Author | Cain, K. P. | |
| Author | MacGregor, R. R. | |
| Author | Achkar, J. M. | |
| Author | Gupta, A. | |
| Author | Veloso, Valdiléa G. | |
| Author | Asmelash, A. | |
| Author | Omoz-Oarhe, A. E | |
| Author | Gengiah, S. | |
| Author | Lalloo, U. | |
| Author | Allen, R. | |
| Author | Shiboski, C. | |
| Author | Andersen, J. | |
| Author | Qasba, S. S. | |
| Author | Katzenstein, D. K. | |
| Author | AIDS Clinical Trials Group 5253 Study Team | |
| Access date | 2018-11-05T16:50:59Z | |
| Available date | 2018-11-05T16:50:59Z | |
| Document date | 2013 | |
| Citation | SWINDELLS, S. et al. Screening for pulmonary tuberculosis in HIV-infected individuals: AIDS Clinical Trials Group Protocol A5253. International Journal of Tuberculosis and Lung Disease, v. 17, n. 4, p. 532-539, 2013. | pt_BR |
| ISSN | 1027-3719 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/29853 | |
| Language | eng | pt_BR |
| Rights | open access | pt_BR |
| Title | Screening for pulmonary tuberculosis in HIV-infected individuals: AIDS Clinical Trials Group Protocol A5253 | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.5588/ijtld.12.0737 | |
| Abstract | BACKGROUND:
Improved tuberculosis (TB) screening is urgently needed for human immunodeficiency virus (HIV) infected patients.
METHODS:
An observational, multi-country, cross-sectional study of HIV-infected patients to compare a standardized diagnostic evaluation (SDE) for TB with standard of care (SOC). SOC evaluations included TB symptom review (current cough, fever, night sweats and/or weight loss), sputum Ziehl-Neelsen staining and chest radiography. SDE screening added extended clinical signs and symptoms and fluorescent microscopy (FM). All participants underwent all evaluations. Mycobacterium tuberculosis on sputum culture was the primary outcome.
RESULTS:
A total of 801 participants were enrolled from Botswana, Malawi, South Africa, Zimbabwe, India, Peru and Brazil. The median age was 33 years; 37% were male, and median CD4 count was 275 cells/mm(3). Thirty-one participants (4%) had a positive culture on Löwenstein-Jensen media and 54 (8%) on MGIT. All but one positive culture came from sub-Saharan Africa, where the prevalence of TB was 54/445 (12%). SOC screening had 54% sensitivity (95%CI 40-67) and 76% specificity (95%CI 72-80). Positive and negative predictive values were respectively 24% and 92%. No elements of the SDE improved the predictive values of SOC.
CONCLUSIONS:
Symptom-based screening with smear microscopy was insufficiently sensitive. More sensitive diagnostic testing is required for HIV-infected patients. | pt_BR |
| Affilliation | University of Nebraska Medical Center. Omaha, NE, USA. | pt_BR |
| Affilliation | Harvard School of Public Health. Boston, MA, USA. | pt_BR |
| Affilliation | National AIDS Research Institute. Pune, India. | pt_BR |
| Affilliation | Centers for Disease Control and Prevention. Atlanta, GA, USA. | pt_BR |
| Affilliation | University of Pennsylvania. Philadelphia, PA, USA. | pt_BR |
| Affilliation | Albert Einstein College of Medicine. Bronx, NY, USA. | pt_BR |
| Affilliation | Johns Hopkins University. Baltimore, MD, USA. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Scottish Livingstone Hospital. Molepolole, Botswana. | pt_BR |
| Affilliation | Princess Marina Hospital. Gaborone, Botswana. | pt_BR |
| Affilliation | Center for the AIDS Programme of Research in South Africa. Durban, South Africa. | pt_BR |
| Affilliation | University of KwaZulu-Natal. Durban, South Africa. | pt_BR |
| Affilliation | AIDS Clinical Trials Group Operations Center. Silver Spring, MD, USA. | pt_BR |
| Affilliation | University of California San Francisco. San Francisco, CA, USA. | pt_BR |
| Affilliation | Harvard School of Public Health. Boston, Massachusetts, USA. | pt_BR |
| Affilliation | Montgomery County Health Department. Silver Spring, MD, USA. | pt_BR |
| Affilliation | Stanford University Medical Center. Stanford, CA, USA. | pt_BR |
| Subject | Tuberculosis | pt_BR |
| Subject | Diagnostics | pt_BR |
| Subject | HIV infection | pt_BR |
| Subject | Sensitivity | pt_BR |
| Subject | Specificity | pt_BR |
