PMID- 23227329
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130422
LR  - 20211021
IS  - 2090-1518 (Electronic)
IS  - 2090-150X (Print)
IS  - 2090-150X (Linking)
VI  - 2012
DP  - 2012
TI  - Performance of Clinical Algorithms for Smear-Negative Tuberculosis in 
      HIV-Infected Persons in Ho Chi Minh City, Vietnam.
PG  - 360852
LID - 10.1155/2012/360852 [doi]
LID - 360852
AB  - Background. Tuberculosis (TB) disease diagnosis in Vietnam relies on symptom 
      screening, chest radiography (CXR), and acid fast bacilli (AFB) sputum smear 
      which have a poor sensitivity in HIV patients. We evaluated the performance of 
      clinical algorithms in screening and diagnosing AFB smear-negative TB in HIV 
      patients. Methods. We enrolled 399 HIV-positive patients seeking care at a HIV 
      clinic in Ho Chi Minh City (HCMC), Vietnam. Participants' demographics, medical 
      history, common TB symptoms, CXR, and laboratory tests were collected. Results. 
      Of 399 HIV patients, 390 had initial AFB-negative smears and 22/390 patients had 
      positive cultures. Symptom screening missed 54% (12/22) of smear-negative 
      pulmonary TB (PTB) cases. Multivariate analysis found CD4+ cell level and CXR 
      were significant PTB predictors. An algorithm combining four TB symptoms and TST 
      presented a high sensitivity (100%), but poorly specific (24%) diagnostic 
      performance for smear-negative PTB. Conclusion. Up to 54% of PTB cases in the 
      HIV-infected population may be missed in the routine screening and diagnostic 
      procedures used in Vietnam. Symptom screening was a poor overall diagnostic 
      measure in detecting smear-negative TB in HIV patients. Our study results suggest 
      that routine sputum cultures should be implemented to achieve a more accurate 
      diagnosis of TB in HIV patients.
FAU - Nguyen, Duc T M
AU  - Nguyen DT
AD  - Department of Pediatrics, University of British Columbia and BC Children's 
      Hospital, 4480 Oak Street, A4-198 AD, Vancouver, BC, Canada V6H 3V4.
FAU - Nguyen, Hung Q
AU  - Nguyen HQ
FAU - Beasley, R Palmer
AU  - Beasley RP
FAU - Ford, Charles E
AU  - Ford CE
FAU - Hwang, Lu-Yu
AU  - Hwang LY
FAU - Graviss, Edward A
AU  - Graviss EA
LA  - eng
GR  - D43 TW007669/TW/FIC NIH HHS/United States
GR  - P30 AI036211/AI/NIAID NIH HHS/United States
PT  - Journal Article
DEP - 20121125
PL  - Egypt
TA  - Tuberc Res Treat
JT  - Tuberculosis research and treatment
JID - 101576351
PMC - PMC3512270
EDAT- 2012/12/12 06:00
MHDA- 2012/12/12 06:01
PMCR- 2012/11/25
CRDT- 2012/12/11 06:00
PHST- 2012/08/27 00:00 [received]
PHST- 2012/10/18 00:00 [revised]
PHST- 2012/10/22 00:00 [accepted]
PHST- 2012/12/11 06:00 [entrez]
PHST- 2012/12/12 06:00 [pubmed]
PHST- 2012/12/12 06:01 [medline]
PHST- 2012/11/25 00:00 [pmc-release]
AID - 10.1155/2012/360852 [doi]
PST - ppublish
SO  - Tuberc Res Treat. 2012;2012:360852. doi: 10.1155/2012/360852. Epub 2012 Nov 25.