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Poor sensitivity and predictive value of diagnostic tests for pulmonary tuberculosis (TB) among HIV patients in a highly TB prevalent setting.


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


Information in this article was accurate in January 30, 1997. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.