Capacities of blood serum lipoarabinomannan in the diagnosis of tuberculosis at a late stage of HIV infection

Introduction: Performance of the immunological TB diagnosis at the advanced stage of HIV-infection depends on the severity of immunodeficiency. A new approach in TB diagnosis has become available – that is identification of the secreted antigens of mycobacteria in blood serum or in urine. It is based on one of the main structural components of the mycobacterial cell walls - lipoarabinomannan (LAM).Purpose of the Study: To assess the diagnostic significance of the blood serum LAM in TB diagnostics in patients with advanced HIV-infection.Materials and Methods: 106 patients at the advanced stage of HIV-infection were evaluated: 65 males and 41 females aged 19 - 62. Evaluation included clinical laboratory examinations, radiological and microbiological examinations (microscopy, PCR, Bactec), and bronchoscopy. CD4 below 100 cells/µl was reported in 65 people (61.3%), CD4 from 100 to 200 cells/µl - in 12 people (11.3%), CD4 over 200 cells/µl - in 29 people (27.4%). The blood serum LAM tests in vitro were performed in 106 people.Results: Of 106 evaluated patients, 63 (59.4%) were diagnosed with tuberculosis and 43 patients (40.6%) had other diseases of the respiratory system. Patients with TB-HIV had a reliably higher levels of lipoarabinomannan in blood serum compared to HIV-positive individuals (13.75 ± 1.5 pg/ml; CI±2.97 and 7.49 ± 0.5 pg/ml; CI±0.96, respectively; P = 0.000163). The sensitivity of serum LAM test is 85.7%, and th...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Tuberculosis Source Type: research