GeneXpert on patients with human immunodeficiency virus and smear-negative pulmonary tuberculosis
Vietnam is a high-prevalence country for tuberculosis (TB). Xpert MTB/RIF is a novel PCR-based diagnostic test that is substantially more sensitive for detecting M. tuberculosis than traditional smear-based techniques. However, locally-derived evidence of Xpert MTB/RIF in HIV-infected people is limi...
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| creator | Cuong, Nguyen Kim Ngoc, Nguyen Bao Hoa, Nguyen Binh Dat, Vu Quoc Nhung, Nguyen Viet |
| description | Vietnam is a high-prevalence country for tuberculosis (TB). Xpert MTB/RIF is a novel PCR-based diagnostic test that is substantially more sensitive for detecting M. tuberculosis than traditional smear-based techniques. However, locally-derived evidence of Xpert MTB/RIF in HIV-infected people is limited. This study evaluates the performance of the Xpert MTB/RIF in HIV-infected patients with smear-negative pulmonary TB (SNTB). This was a cross-sectional study in 3 hospitals. The performance of Xpert MTB/RIF was compared with the reference standard of liquid culture and phenotypic drug-susceptibility testing for rifampicin (RIF) resistance. Out of 123 patients, the median age was 37.0 (IQR: 32.0-41.0) and 81.3% were male. The area under the receiver operating characteristic curve, sensitivity (Se) and specificity (Sp) of Xpert MTB/RIF for pulmonary TB diagnosis were 0.72 (95% confidence interval [CI]: 0.63-0.81), 66.7% (95%CI: 54.8-77.1) and 77.1% (95%CI: 62.7-88.0), respectively, while Se and Sp of Xpert MTB/RIF in detecting RIF resistance were 50.0 (11.8-88.2) and 86.4% (95%CI: 72.7-94.8). The performance of Xpert MTB/RIF in HIV-infected patients with SNTB for the diagnosis of TB and RIF-resistance was low. Further studies are required to evaluate the results of Xpert MTB/RIF assay in HIV-infected patients with SNTB and the role of Xpert repetition on the same specimens. |
| doi_str_mv | 10.1371/journal.pone.0253961 |
| format | Article |
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Xpert MTB/RIF is a novel PCR-based diagnostic test that is substantially more sensitive for detecting M. tuberculosis than traditional smear-based techniques. However, locally-derived evidence of Xpert MTB/RIF in HIV-infected people is limited. This study evaluates the performance of the Xpert MTB/RIF in HIV-infected patients with smear-negative pulmonary TB (SNTB). This was a cross-sectional study in 3 hospitals. The performance of Xpert MTB/RIF was compared with the reference standard of liquid culture and phenotypic drug-susceptibility testing for rifampicin (RIF) resistance. Out of 123 patients, the median age was 37.0 (IQR: 32.0-41.0) and 81.3% were male. The area under the receiver operating characteristic curve, sensitivity (Se) and specificity (Sp) of Xpert MTB/RIF for pulmonary TB diagnosis were 0.72 (95% confidence interval [CI]: 0.63-0.81), 66.7% (95%CI: 54.8-77.1) and 77.1% (95%CI: 62.7-88.0), respectively, while Se and Sp of Xpert MTB/RIF in detecting RIF resistance were 50.0 (11.8-88.2) and 86.4% (95%CI: 72.7-94.8). The performance of Xpert MTB/RIF in HIV-infected patients with SNTB for the diagnosis of TB and RIF-resistance was low. Further studies are required to evaluate the results of Xpert MTB/RIF assay in HIV-infected patients with SNTB and the role of Xpert repetition on the same specimens.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0253961</identifier><identifier>PMID: 34228759</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Biology and Life Sciences ; Complications and side effects ; Confidence intervals ; Diagnosis ; Disease ; Evaluation ; HIV ; HIV (Viruses) ; Hospitals ; Human immunodeficiency virus ; Hypotheses ; Laboratories ; Liquid culture ; Medical diagnosis ; Medical tests ; Medicine and Health Sciences ; Microscopy ; Patient outcomes ; Patients ; Performance evaluation ; Public health ; Rifampin ; Risk factors ; Tuberculosis ; Viruses</subject><ispartof>PloS one, 2021-07, Vol.16 (7), p.e0253961-e0253961</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Cuong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Xpert MTB/RIF is a novel PCR-based diagnostic test that is substantially more sensitive for detecting M. tuberculosis than traditional smear-based techniques. However, locally-derived evidence of Xpert MTB/RIF in HIV-infected people is limited. This study evaluates the performance of the Xpert MTB/RIF in HIV-infected patients with smear-negative pulmonary TB (SNTB). This was a cross-sectional study in 3 hospitals. The performance of Xpert MTB/RIF was compared with the reference standard of liquid culture and phenotypic drug-susceptibility testing for rifampicin (RIF) resistance. Out of 123 patients, the median age was 37.0 (IQR: 32.0-41.0) and 81.3% were male. The area under the receiver operating characteristic curve, sensitivity (Se) and specificity (Sp) of Xpert MTB/RIF for pulmonary TB diagnosis were 0.72 (95% confidence interval [CI]: 0.63-0.81), 66.7% (95%CI: 54.8-77.1) and 77.1% (95%CI: 62.7-88.0), respectively, while Se and Sp of Xpert MTB/RIF in detecting RIF resistance were 50.0 (11.8-88.2) and 86.4% (95%CI: 72.7-94.8). The performance of Xpert MTB/RIF in HIV-infected patients with SNTB for the diagnosis of TB and RIF-resistance was low. Further studies are required to evaluate the results of Xpert MTB/RIF assay in HIV-infected patients with SNTB and the role of Xpert repetition on the same specimens.</description><subject>Biology and Life Sciences</subject><subject>Complications and side effects</subject><subject>Confidence intervals</subject><subject>Diagnosis</subject><subject>Disease</subject><subject>Evaluation</subject><subject>HIV</subject><subject>HIV (Viruses)</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Hypotheses</subject><subject>Laboratories</subject><subject>Liquid culture</subject><subject>Medical diagnosis</subject><subject>Medical tests</subject><subject>Medicine and Health Sciences</subject><subject>Microscopy</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Performance evaluation</subject><subject>Public health</subject><subject>Rifampin</subject><subject>Risk 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cuong, Nguyen Kim</au><au>Ngoc, Nguyen Bao</au><au>Hoa, Nguyen Binh</au><au>Dat, Vu Quoc</au><au>Nhung, Nguyen Viet</au><au>Anupurba, Shampa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>GeneXpert on patients with human immunodeficiency virus and smear-negative pulmonary tuberculosis</atitle><jtitle>PloS one</jtitle><date>2021-07-06</date><risdate>2021</risdate><volume>16</volume><issue>7</issue><spage>e0253961</spage><epage>e0253961</epage><pages>e0253961-e0253961</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Vietnam is a high-prevalence country for tuberculosis (TB). Xpert MTB/RIF is a novel PCR-based diagnostic test that is substantially more sensitive for detecting M. tuberculosis than traditional smear-based techniques. However, locally-derived evidence of Xpert MTB/RIF in HIV-infected people is limited. This study evaluates the performance of the Xpert MTB/RIF in HIV-infected patients with smear-negative pulmonary TB (SNTB). This was a cross-sectional study in 3 hospitals. The performance of Xpert MTB/RIF was compared with the reference standard of liquid culture and phenotypic drug-susceptibility testing for rifampicin (RIF) resistance. Out of 123 patients, the median age was 37.0 (IQR: 32.0-41.0) and 81.3% were male. The area under the receiver operating characteristic curve, sensitivity (Se) and specificity (Sp) of Xpert MTB/RIF for pulmonary TB diagnosis were 0.72 (95% confidence interval [CI]: 0.63-0.81), 66.7% (95%CI: 54.8-77.1) and 77.1% (95%CI: 62.7-88.0), respectively, while Se and Sp of Xpert MTB/RIF in detecting RIF resistance were 50.0 (11.8-88.2) and 86.4% (95%CI: 72.7-94.8). The performance of Xpert MTB/RIF in HIV-infected patients with SNTB for the diagnosis of TB and RIF-resistance was low. Further studies are required to evaluate the results of Xpert MTB/RIF assay in HIV-infected patients with SNTB and the role of Xpert repetition on the same specimens.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34228759</pmid><doi>10.1371/journal.pone.0253961</doi><tpages>e0253961</tpages><orcidid>https://orcid.org/0000-0002-5904-5970</orcidid><orcidid>https://orcid.org/0000-0001-6026-2270</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Biology and Life Sciences Complications and side effects Confidence intervals Diagnosis Disease Evaluation HIV HIV (Viruses) Hospitals Human immunodeficiency virus Hypotheses Laboratories Liquid culture Medical diagnosis Medical tests Medicine and Health Sciences Microscopy Patient outcomes Patients Performance evaluation Public health Rifampin Risk factors Tuberculosis Viruses |
| title | GeneXpert on patients with human immunodeficiency virus and smear-negative pulmonary tuberculosis |
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