Xpert MTB/RIF on urine samples to increase diagnosis of TB in people living with HIV in Guinea-Bissau
Objectives: We investigated if Xpert MTB/RIF (Xpert) testing on urine samples among newly diagnosed HIV-patients as an adjunctive test to Xpert testing on sputum increases diagnosis. We sought to define subgroups of patients, for whom testing with either test is especially advantageous. Methods: We...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971222001746 |
| _version_ | 1811178728133230592 |
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| author | Alexander Dutschke Ditte Steiniche Sanne Jespersen Joao Paulo Nanque Candida Medina Bo Langhoff Hønge Christian Wejse |
| author_facet | Alexander Dutschke Ditte Steiniche Sanne Jespersen Joao Paulo Nanque Candida Medina Bo Langhoff Hønge Christian Wejse |
| author_sort | Alexander Dutschke |
| collection | DOAJ |
| description | Objectives: We investigated if Xpert MTB/RIF (Xpert) testing on urine samples among newly diagnosed HIV-patients as an adjunctive test to Xpert testing on sputum increases diagnosis. We sought to define subgroups of patients, for whom testing with either test is especially advantageous. Methods: We included patients >15 years, newly diagnosed with HIV, that delivered a urine sample on the day of HIV-diagnosis at the biggest HIV-clinic in Guinea-Bissau between September 5, 2016 and October 13, 2017 into a cross-sectional study. Patients were asked for a sputum sample, which was Xpert tested if returned within 30 days. A questionnaire and physical examination were completed on day of inclusion. Results: We included 390 patients. TB prevalence was 12.6%. Adding Xpert urine test to all newly diagnosed HIV-patients increased diagnostic yield of TB by 58% compared with testing on sputum alone. Patients who tested positive by Xpert on urine samples were clinically similar to those tested with sputum, except that the sputum positives reported more cough (p=0.03). Conclusions: Indiscriminate Xpert urine testing in newly diagnosed HIV-patients with advanced disease increased diagnostic yield. Xpert testing for TB on urine and sputum should be offered as screening in Guinea-Bissau and possibly in similar settings. |
| first_indexed | 2024-04-11T06:24:16Z |
| format | Article |
| id | doaj.art-8da3f99ffa88445e823413c8dcfaaeb9 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-04-11T06:24:16Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-8da3f99ffa88445e823413c8dcfaaeb92022-12-22T04:40:28ZengElsevierInternational Journal of Infectious Diseases1201-97122022-11-01124S63S68Xpert MTB/RIF on urine samples to increase diagnosis of TB in people living with HIV in Guinea-BissauAlexander Dutschke0Ditte Steiniche1Sanne Jespersen2Joao Paulo Nanque3Candida Medina4Bo Langhoff Hønge5Christian Wejse6Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, Denmark; Corresponding author: Alexander Dutschke, Department of Infectious Diseases, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark, Telephone: +45 52178273Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, DenmarkBandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, DenmarkBandim Health Project, Indepth Network, Bissau, Guinea-Bissau; National HIV Programme, Ministry of Health, Bissau, Guinea-BissauNational HIV Programme, Ministry of Health, Bissau, Guinea-BissauBandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, Denmark; Department of Clinical Immunology, Aarhus University Hospital, DenmarkBandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, Denmark; GloHAU, Center for Global Health, School of Public Health, Aarhus University, DenmarkObjectives: We investigated if Xpert MTB/RIF (Xpert) testing on urine samples among newly diagnosed HIV-patients as an adjunctive test to Xpert testing on sputum increases diagnosis. We sought to define subgroups of patients, for whom testing with either test is especially advantageous. Methods: We included patients >15 years, newly diagnosed with HIV, that delivered a urine sample on the day of HIV-diagnosis at the biggest HIV-clinic in Guinea-Bissau between September 5, 2016 and October 13, 2017 into a cross-sectional study. Patients were asked for a sputum sample, which was Xpert tested if returned within 30 days. A questionnaire and physical examination were completed on day of inclusion. Results: We included 390 patients. TB prevalence was 12.6%. Adding Xpert urine test to all newly diagnosed HIV-patients increased diagnostic yield of TB by 58% compared with testing on sputum alone. Patients who tested positive by Xpert on urine samples were clinically similar to those tested with sputum, except that the sputum positives reported more cough (p=0.03). Conclusions: Indiscriminate Xpert urine testing in newly diagnosed HIV-patients with advanced disease increased diagnostic yield. Xpert testing for TB on urine and sputum should be offered as screening in Guinea-Bissau and possibly in similar settings.http://www.sciencedirect.com/science/article/pii/S1201971222001746TBHIVdiagnostic yieldXperturineGuinea-Bissau |
| spellingShingle | Alexander Dutschke Ditte Steiniche Sanne Jespersen Joao Paulo Nanque Candida Medina Bo Langhoff Hønge Christian Wejse Xpert MTB/RIF on urine samples to increase diagnosis of TB in people living with HIV in Guinea-Bissau International Journal of Infectious Diseases TB HIV diagnostic yield Xpert urine Guinea-Bissau |
| title | Xpert MTB/RIF on urine samples to increase diagnosis of TB in people living with HIV in Guinea-Bissau |
| title_full | Xpert MTB/RIF on urine samples to increase diagnosis of TB in people living with HIV in Guinea-Bissau |
| title_fullStr | Xpert MTB/RIF on urine samples to increase diagnosis of TB in people living with HIV in Guinea-Bissau |
| title_full_unstemmed | Xpert MTB/RIF on urine samples to increase diagnosis of TB in people living with HIV in Guinea-Bissau |
| title_short | Xpert MTB/RIF on urine samples to increase diagnosis of TB in people living with HIV in Guinea-Bissau |
| title_sort | xpert mtb rif on urine samples to increase diagnosis of tb in people living with hiv in guinea bissau |
| topic | TB HIV diagnostic yield Xpert urine Guinea-Bissau |
| url | http://www.sciencedirect.com/science/article/pii/S1201971222001746 |
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