Int Conf AIDS. 1996 Jul 7-12;11(1):168 (abstract no. Mo.C.1661). Unique
Objective: To measure the value of tests usually available for diagnosis
of pulmonary Tb in primary care centers providing care for groups at
risk for HIV infection. Methods: Ambulatory patients attending HIV
screening centers were examined for active pulmonary Tb (clinical
history, Rx, PPD, AFB smear and culture) and HIV infection (ELISA-WB).
Results: 2668 patients were screened, bacteriologically confirmed
pulmonary M. tuberculosis was found in 27 (1.0%) patients. HIV infection
was diagnosed in 56%; 19 pulmonary Tb cases were diagnosed in this
group. Comparison of different tests vs culture confirmed M.tuberculosis
according to HIV was as follows:(table: see text) Conclusions:
Sensitivity and positive predictive value of available tests is very
poor compared to usage of cultures for M. tuberculosis among this group.
Rx and AFB have lower sensitivity and positive predictive value among
HIV-positive patients for diagnosis of pulmonary Tb. Prevailing policies
should be modified for the diagnosis of Tb among this population.
Availability of cultures should be extended to primary care centers.
*HIV Infections/COMPLICATIONS *Tuberculosis, Pulmonary/DIAGNOSIS