Screening for HIV-Associated Tuberculosis and Rifampicin Resistance before Antiretroviral Therapy Using the Xpert MTB/RIF Assay: A Prospective Study
2011

Screening for HIV-Associated Tuberculosis Using the Xpert MTB/RIF Assay

Sample size: 515 publication 10 minutes Evidence: high

Author Information

Author(s): Lawn Stephen D., Brooks Sophie V., Kranzer Katharina, Nicol Mark P., Whitelaw Andrew, Vogt Monica, Bekker Linda-Gail, Wood Robin

Primary Institution: University of Cape Town

Hypothesis

Can the Xpert MTB/RIF assay improve tuberculosis detection in HIV-positive patients before starting antiretroviral therapy?

Conclusion

The Xpert MTB/RIF assay increased tuberculosis case detection by 45% compared to smear microscopy in HIV-positive patients at high risk of TB.

Supporting Evidence

  • Xpert MTB/RIF detected 73.3% of culture-positive TB cases.
  • Smear microscopy only detected 28% of TB cases.
  • Xpert MTB/RIF assay increased TB case detection by 45% compared to smear microscopy.

Takeaway

This study shows that a new test can find more cases of tuberculosis in people with HIV, helping them get treated faster.

Methodology

The study involved recruiting HIV-infected patients without a current TB diagnosis and comparing the Xpert MTB/RIF assay with other diagnostic tests.

Potential Biases

Potential bias due to the study being conducted in a specific population with high TB prevalence.

Limitations

The study was conducted in a single setting, which may limit the generalizability of the findings.

Participant Demographics

Adult HIV-infected patients in a South African township, median CD4 count of 171 cells/µl.

Statistical Information

P-Value

p<0.01

Confidence Interval

95% CI, 13.9–20.7

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pmed.1001067

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