Universidad Peruana Cayetano Heredia
A diagnostic accuracy study of Xpert®MTB/RIF in HIV-positive patients with high clinical suspicion of pulmonary tuberculosis in Lima, Peru.
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| 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 | |
| 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 |
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