BOSTON – Urine-based screening for tuberculosis added to standard sputum-based screening can reduce the risk of TB-associated deaths among hospitalized patients with advanced HIV compared with sputum-based screening alone, results of a randomized trial indicate.
Among 2,574 hospitalized HIV-positive patients, the rate of death at 56 days, the primary endpoint, was 21.1% for patients screened with standard-of-care sputum testing using the Xpert MTB/RIF assay, compared with 18.3% for patients screened with sputum testing and urine-sample testing by the Xpert MTB/RIF and the Determine TB-LAM urine dipstick test, reported Ankur Gupta-Wright, MBBS, MRCP, from the London School of Hygiene and Tropical Medicine.
Dr. Ankur Gupta-Wright
However, the reductions in mortality seen with the urine-based screening were observed only in the patients with more advanced HIV infections (CD4 cell counts below 100/uL), he said at the annual Conference on Retroviruses and Opportunistic Infections (CROI).
“For every 100 patients who are HIV-positive admitted to hospital, with screening for TB using new urine-based testing in addition to sputum testing we can diagnose approximately seven extra TB case, and save approximately three lives,” he said at a briefing following his presentation of the data in a late-breaking oral abstract session.
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