{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T12:20:28Z","timestamp":1793017228632,"version":"4.5.0"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013831","name":"Universitatea de Medicin\u0103 \u015fi Farmacie din Craiova","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013831","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Tuberculosis (TB) is the leading infectious cause of mortality worldwide. In the last years, resistant strains of the etiological agent,\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      , have emerged, thus demanding more triage tests to identify active pulmonary TB (PTB) patients and to evaluate their disease severity. Therefore, acute-phase reaction serum tests are required for monitoring TB patients, among WHO symptom screening recommendations. C-reactive protein (CRP) is a non-specific inflammatory biomarker that has been recently proposed for TB screening and can be quantitatively analyzed through cost-effective point-of-care assays. A previous meta-analysis found CRP to be highly sensitive and moderately specific for active PTB with confirmed HIV infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a meta-analysis update of diagnostic tests, pooling sensitivities, and specificities in order to assess the accuracy of CRP as a potential test for the screening of HIV-associated PTB in outpatients. We searched MEDLINE, Web of Science, and SCOPUS for eligible articles before 19 October 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 13 eligible studies with HIV-positive patients with PTB. At a CRP threshold of 10 mg\/L, CRP pooled sensitivity was 87% (76%\u201393%) and pooled specificity was 67% (49%\u201381%), with an area under the curve (AUC) of 0.858. Using a CRP threshold of 8 mg\/L, pooled sensitivity was 82% (72%\u201389%) and pooled specificity was 82% (67%\u201392%), with an AUC of 0.879. We found that CRP has a high sensitivity in the screening of PTB in HIV-positive outpatients, consistent with findings reported previously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Regardless of pooled specificity, better results were found using the CRP threshold of 8 mg\/L as a test screening of PTB, meeting the need of further approaching specific TB diagnostic methods and reducing resource consumption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2022.891201","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T04:54:41Z","timestamp":1661403281000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Screening performance of C-reactive protein for active pulmonary tuberculosis in HIV-positive patients: A systematic review with a 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