Peripheral blood PCR for detection of Mycobacterium tuberculosis in patients with Hiv/Aids In Mumbai, India

Rajiv Hira, Vishwas Sarangdhar, S. Hira, H. Dupont
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引用次数: 1

Abstract

Background: Since the co-infection of Mycobacterium tuberculosis (MTB) and HIV is recognized as a lethal combination, there is need for a reliable diagnostic test that can be conducted on a readily available specimen such as peripheral blood to periodically screen HIV-infected individuals for MTB at an early stage. Methods: A study was designed to assess the diagnostic value of PCR targeted to IS 1081 in peripheral blood of HIV-infected individuals because of ease of obtaining periodic samples. A cohort of 129 individuals was recruited for this purpose. It contained of adult, non-pregnant HIV sero-positive as well as HIV sero-negative individuals who were naïve to anti-Koch’s treatment at two teaching hospitals in Mumbai. Results: The cohort of 129 individuals was categorized into 5 groups based on their clinical TB and HIV status. The mean CD4 count for TB+HIV+(Groups 1,2,3) ranged between 381 and 525 cells/cmm suggesting early to moderate immune suppression.TB PCR assay was compared with the ‘gold’ standard, namely the LJ culture in each of the 5 groups. Overall, the sensitivity of PCR was 83.3% and specificity was 97.1%. PCR+ LJ-were subjected to sequential TB PCR tests at intervals of two weeks after initiation of AKT.TB PCR+ patients converted to TB PCR negative between 6-8 weeks. Conclusions: The study established that PCR targeted to IS 1081 is a valuable test for early diagnosis of TB from peripheral blood at an early point of TB activation when most patients (>85%) did not produce other traditional specimens such as the sputum and/or pleural fluid.
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在印度孟买检测艾滋病毒/艾滋病患者外周血结核分枝杆菌的PCR
背景:由于结核分枝杆菌(MTB)和艾滋病毒的联合感染被认为是一种致命的组合,因此需要一种可靠的诊断测试,可以在容易获得的标本(如外周血)上进行,以便在早期阶段定期筛查艾滋病毒感染者的MTB。方法:由于易于获得定期样本,本研究旨在评估针对IS 1081的PCR在hiv感染者外周血中的诊断价值。为此目的招募了129人。其中包括成人、非怀孕艾滋病毒血清阳性和艾滋病毒血清阴性的人,他们在孟买的两家教学医院naïve接受抗科赫治疗。结果:129名个体根据临床结核和艾滋病毒感染情况被分为5组。TB+HIV+(1、2、3组)的平均CD4细胞计数在381至525个细胞/cmm之间,表明早期至中度免疫抑制。将TB PCR检测与“金”标准进行比较,即5组中每组的LJ培养。总体而言,PCR的敏感性为83.3%,特异性为97.1%。PCR+ lj在AKT启动后每隔两周进行顺序TB PCR检测。结核聚合酶链反应阳性患者在6-8周内转化为结核聚合酶链反应阴性。结论:该研究证实,当大多数患者(>85%)没有痰和/或胸膜液等其他传统标本时,针对IS 1081的PCR是一种有价值的早期结核病激活点外周血早期诊断方法。
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