TY - JOUR
T1 - Lateral flow urine lipoarabinomannan assay for extrapulmonary tuberculosis diagnosis in adults who are HIV-positive
AU - Indirawati, Ni Nyoman
AU - Yunihastuti, Evy
AU - Yulianti, Mira
AU - Nasir, Ujainah Zaini
AU - Wulandari, Dewi
AU - Rinaldi, Ikhwan
N1 - Publisher Copyright:
© 2022 The Author(s)
PY - 2022/9
Y1 - 2022/9
N2 - Background: The diagnosis of extrapulmonary tuberculosis (EPTB) in patients with HIV remains a challenge for clinicians. The World Health Organization recommends the detection of lipoarabinomannan (LAM) for diagnosing pulmonary tuberculosis in patients with HIV. A new generation of urine LAM tests (FujiLAM®) is available. However, studies regarding its accuracy are limited. Objective: This study aimed to evaluate the accuracy of urine LAM tests using FujiLAM® for diagnosing EPTB in patients with HIV. Methods: A cross-sectional study using urine samples of patients at Cipto Mangunkusumo Hospital, Indonesia, was performed from January 2020 to December 2020. Fresh urine was applied to the FujiLAM®. Patients were grouped into definitive, probable, and non-TB groups. The diagnostic accuracy of the urine LAM test was compared with other Mycobacterium tuberculosis specimen gold standard tests. Results: Among 62 patients, 16 patients (25.8%) had definitive diagnosis of EPTB. Among those with definitive TB, an urine LAM test yielded a sensitivity of 75% (95% confidence interval [CI]: 47.62-92.73%) and specificity of 73.91% (95% CI: 87-85.73%). Meanwhile, compared with all diagnostic tests (definite + probable TB), FujiLAM® had a sensitivity value of 61% (95% CI 43.36-76.86%) and a specificity value of 92.31% (95% CI 74.87-99.05%). Conclusion: The FujiLAM® test is a feasible method for diagnosing EPTB in patients with HIV.
AB - Background: The diagnosis of extrapulmonary tuberculosis (EPTB) in patients with HIV remains a challenge for clinicians. The World Health Organization recommends the detection of lipoarabinomannan (LAM) for diagnosing pulmonary tuberculosis in patients with HIV. A new generation of urine LAM tests (FujiLAM®) is available. However, studies regarding its accuracy are limited. Objective: This study aimed to evaluate the accuracy of urine LAM tests using FujiLAM® for diagnosing EPTB in patients with HIV. Methods: A cross-sectional study using urine samples of patients at Cipto Mangunkusumo Hospital, Indonesia, was performed from January 2020 to December 2020. Fresh urine was applied to the FujiLAM®. Patients were grouped into definitive, probable, and non-TB groups. The diagnostic accuracy of the urine LAM test was compared with other Mycobacterium tuberculosis specimen gold standard tests. Results: Among 62 patients, 16 patients (25.8%) had definitive diagnosis of EPTB. Among those with definitive TB, an urine LAM test yielded a sensitivity of 75% (95% confidence interval [CI]: 47.62-92.73%) and specificity of 73.91% (95% CI: 87-85.73%). Meanwhile, compared with all diagnostic tests (definite + probable TB), FujiLAM® had a sensitivity value of 61% (95% CI 43.36-76.86%) and a specificity value of 92.31% (95% CI 74.87-99.05%). Conclusion: The FujiLAM® test is a feasible method for diagnosing EPTB in patients with HIV.
KW - Extrapulmonary tuberculosis
KW - Human immunodeficiency virus
KW - Lateral flow urine lipoarabinomannan assay
KW - LF-LAM
KW - Lipoarabinomannan
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=85133463595&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2022.06.007
DO - 10.1016/j.ijid.2022.06.007
M3 - Article
C2 - 35690363
AN - SCOPUS:85133463595
SN - 1201-9712
VL - 122
SP - 415
EP - 419
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -
