{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T04:15:49Z","timestamp":1768536949039,"version":"3.49.0"},"reference-count":0,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["int j tuberc lung dis"],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> TB diagnosis in patients with HIV is challenging due to the lower sensitivities across tests. Molecular tests are preferred and the Xpert<jats:sup>\u00ae<\/jats:sup> MTB\/RIF assay has limitations in lower-income settings. We evaluated the performance of loop-mediated isothermal\n amplification (LAMP) and the lipoarabinomannan (LAM) test in HIV-positive, ART-na\u00efve clinic patients.<jats:bold>METHODS:<\/jats:bold> A total of 783 eligible patients were enrolled; three spot sputum samples of 646 patients were tested using TB-LAMP, Xpert, smear microscopy and culture, while 649\n patients had TB-LAM testing. Sensitivity, specificity, and negative and positive predictive values were estimated with 95% confidence intervals.<jats:bold>RESULTS:<\/jats:bold> Sensitivities for smear microscopy, TB-LAMP and Xpert were respectively 50%, 63% and 74% compared to culture, with specificities\n of respectively 99.2%, 98.5% and 97.5%. An additional eight were positive on TB-LAM alone. Seventy TB patients (9%) were detected using standard-of-care testing, an additional 27 (3%) were detected using study testing. Treatment was initiated in 57\/70 (81%) clinic patients, but only in 56%\n (57\/97) of all those with positive TB tests; 4\/8 multidrug-resistant samples were detected using Xpert.<jats:bold>CONCLUSION:<\/jats:bold> TB diagnostics continue to miss cases in this high-burden setting. TB-LAMP was more sensitive than smear microscopy, and if followed by culture and drug susceptibility\n testing as required, can diagnose TB in HIV-positive patients. TB-LAM is a useful add-in test and both tests at the point-of-care would maximise yield.<\/jats:p>","DOI":"10.5588\/ijtld.21.0195","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T04:32:33Z","timestamp":1645677153000},"page":"224-231","source":"Crossref","is-referenced-by-count":13,"title":["TB testing in HIV-positive patients prior to antiretroviral treatment"],"prefix":"10.5588","volume":"26","author":[{"given":"E.","family":"Spooner","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa, HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Reddy","sequence":"additional","affiliation":[{"name":"South African Medical Research Council, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Ntoyanto","sequence":"additional","affiliation":[{"name":"HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Sakadavan","sequence":"additional","affiliation":[{"name":"HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Reddy","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, South African Medical Research Council, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Mahomed","sequence":"additional","affiliation":[{"name":"School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa, Medical Microbiology Department, National Health Laboratory Services, Durban, South Africa, Centre for AIDS Programme Research in South Africa,\n Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Mlisana","sequence":"additional","affiliation":[{"name":"School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa, Medical Microbiology Department, National Health Laboratory Services, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Dlamini","sequence":"additional","affiliation":[{"name":"Medical Microbiology Department, National Health Laboratory Services, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Daniels","sequence":"additional","affiliation":[{"name":"HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Luthuli","sequence":"additional","affiliation":[{"name":"EThekwini Health Unit, EThekwini Municipality, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Ngomane","sequence":"additional","affiliation":[{"name":"Occupational Health, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Kiepiela","sequence":"additional","affiliation":[{"name":"South African Medical Research Council, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Coutsoudis","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3554","container-title":["The International Journal of Tuberculosis and Lung Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/iuatld\/ijtld\/2022\/00000026\/00000003\/art00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T04:34:06Z","timestamp":1652848446000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.5588\/ijtld.21.0195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3,1]]}},"alternative-id":["1027-3719(20220301)26:3L.224;1-"],"URL":"https:\/\/doi.org\/10.5588\/ijtld.21.0195","relation":{},"ISSN":["1027-3719"],"issn-type":[{"value":"1027-3719","type":"print"}],"subject":[],"published":{"date-parts":[[2022,3,1]]}}}