dc.contributor.author |
Carriquiry, Gabriela |
|
dc.contributor.author |
Otero Vegas, Larissa |
|
dc.contributor.author |
González Lagos, Elsa Violeta |
|
dc.contributor.author |
Zamudio Fuertes, Carlos Eduardo |
|
dc.contributor.author |
Sánchez, Eduardo |
|
dc.contributor.author |
Nabeta, Pamela |
|
dc.contributor.author |
Campos, Miguel |
|
dc.contributor.author |
Echevarria Zarate, Juan Ignacio |
|
dc.contributor.author |
Seas Ramos, Carlos Rafael |
|
dc.contributor.author |
Gotuzzo Herencia, José Eduardo |
|
dc.date.accessioned |
2022-01-18T19:34:39Z |
|
dc.date.available |
2022-01-18T19:34:39Z |
|
dc.date.issued |
2012 |
|
dc.identifier.uri |
https://hdl.handle.net/20.500.12866/11104 |
|
dc.description.abstract |
Background: Diagnosis of pulmonary tuberculosis (TB) among human immunodeficiency virus (HIV) patients remains complex and demands easy to perform and accurate tests. Xpert®MTB/RIF (MTB/RIF) is a molecular TB diagnostic test which is rapid and convenient; the test requires minimal human resources and reports results within two hours. The majority of performance studies of MTB/RIF have been performed in high HIV burden settings, thus TB diagnostic studies among HIV patients in low HIV prevalence settings such as Peru are still needed. METHODOLOGY/PRINCIPAL FINDINGS: From April to May , HIV-positive patients with high clinical suspicion of TB were enrolled from two tertiary hospitals in Lima, Peru. Detection of TB by MTB/RIF was compared to a composite reference standard Löwenstein-Jensen (LJ) and liquid culture. Detection of rifampicin resistance was compared to the LJ proportion method. We included 131 patients, the median CD4 cell count was 154.5 cells/mm(3) and 45 (34.4%) had TB. For TB detection among HIV patients, sensitivity of MTB/RIF was 97.8% (95% CI 88.4-99.6) (44/45); specificity was 97.7% (95% CI 91.9-99.4) (84/86); the positive predictive value was 95.7% (95% CI 85.5-98.8) (44/46); and the negative predictive value, 98.8% (95% CI 93.6-99.8) (84/85). MTB/RIF detected 13/14 smear-negative TB cases, outperforming smear microscopy [97.8% (44/45) vs. 68.9% (31/45); p = 0.0002]. For rifampicin resistance detection, sensitivity of MTB/RIF was 100% (95% CI 61.0-100.0) (6/6); specificity was 91.0% (95% CI 76.4-96.9) (30/33); the positive predictive value was 66.7% (95% CI 35.4-87.9) (6/9); and the negative predictive value was 100% (95% CI 88.7 -100.0) (30/30). CONCLUSIONS/SIGNIFICANCE: In HIV patients in our population with a high clinical suspicion of TB, MTB/RIF performed well for TB diagnosis and outperformed smear microscopy. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
Public Library of Science |
|
dc.relation.ispartofseries |
PLoS ONE |
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dc.rights |
info:eu-repo/semantics/restrictedAccess |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
|
dc.subject |
Humans |
en_US |
dc.subject |
Peru |
en_US |
dc.subject |
article |
en_US |
dc.subject |
controlled study |
en_US |
dc.subject |
major clinical study |
en_US |
dc.subject |
diagnostic test |
en_US |
dc.subject |
sex difference |
en_US |
dc.subject |
rifampicin |
en_US |
dc.subject |
HIV Infections |
en_US |
dc.subject |
Human immunodeficiency virus |
en_US |
dc.subject |
molecular diagnosis |
en_US |
dc.subject |
Sensitivity and Specificity |
en_US |
dc.subject |
Sputum |
en_US |
dc.subject |
Human immunodeficiency virus infected patient |
en_US |
dc.subject |
bacterium culture |
en_US |
dc.subject |
diagnostic test accuracy study |
en_US |
dc.subject |
lung tuberculosis |
en_US |
dc.subject |
sputum smear |
en_US |
dc.subject |
Tuberculosis, Pulmonary |
en_US |
dc.subject |
CD4 lymphocyte count |
en_US |
dc.subject |
outcome assessment |
en_US |
dc.subject |
Antitubercular Agents |
en_US |
dc.subject |
ethambutol |
en_US |
dc.subject |
isoniazid |
en_US |
dc.subject |
pyrazinamide |
en_US |
dc.subject |
diagnostic accuracy |
en_US |
dc.subject |
Rifampin |
en_US |
dc.subject |
predictive value |
en_US |
dc.subject |
microscopy |
en_US |
dc.subject |
Lowenstein Jensen culture |
en_US |
dc.subject |
Lowenstein Jensen proportion method |
en_US |
dc.subject |
MTB RIF assay |
en_US |
dc.subject |
mycobacteria growth indicator tube |
en_US |
dc.title |
A diagnostic accuracy study of Xpert®MTB/RIF in HIV-positive patients with high clinical suspicion of pulmonary tuberculosis in Lima, Peru. |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1371/journal.pone.0044626 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.01.00 |
|
dc.relation.issn |
1932-6203 |
|