GeneXpert on patients with human immunodeficiency virus and smear-negative pulmonary tuberculosis

Nguyen Kim Cuong; Nguyen Bao Ngoc; Nguyen Binh Hoa; Vu Quoc Dat; Nguyen Viet Nhung

doi:10.1371/journal.pone.0253961

GeneXpert on patients with human immunodeficiency virus and smear-negative pulmonary tuberculosis

PLoS One. 2021 Jul 6;16(7):e0253961. doi: 10.1371/journal.pone.0253961. eCollection 2021.

Authors

Nguyen Kim Cuong^{1

2}, Nguyen Bao Ngoc³, Nguyen Binh Hoa⁴, Vu Quoc Dat⁵, Nguyen Viet Nhung⁴

Affiliations

¹ Department of Tuberculosis and Lung Disease, Hanoi Medical University, Hanoi, Vietnam.
² Department of Respiratory Tuberculosis, National Lung Hospital, Hanoi, Vietnam.
³ Department of Pharmacy, National Lung Hospital, Hanoi, Vietnam.
⁴ National Tuberculosis Programme, Hanoi, Vietnam.
⁵ Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam.

Abstract

Objectives: Vietnam is a high-prevalence country for tuberculosis (TB). Xpert MTB/RIF is a novel PCR-based diagnostic test that is substantially more sensitive for detecting M. tuberculosis than traditional smear-based techniques. However, locally-derived evidence of Xpert MTB/RIF in HIV-infected people is limited. This study evaluates the performance of the Xpert MTB/RIF in HIV-infected patients with smear-negative pulmonary TB (SNTB).

Methods: This was a cross-sectional study in 3 hospitals. The performance of Xpert MTB/RIF was compared with the reference standard of liquid culture and phenotypic drug-susceptibility testing for rifampicin (RIF) resistance.

Results: Out of 123 patients, the median age was 37.0 (IQR: 32.0-41.0) and 81.3% were male. The area under the receiver operating characteristic curve, sensitivity (Se) and specificity (Sp) of Xpert MTB/RIF for pulmonary TB diagnosis were 0.72 (95% confidence interval [CI]: 0.63-0.81), 66.7% (95%CI: 54.8-77.1) and 77.1% (95%CI: 62.7-88.0), respectively, while Se and Sp of Xpert MTB/RIF in detecting RIF resistance were 50.0 (11.8-88.2) and 86.4% (95%CI: 72.7-94.8).

Conclusion: The performance of Xpert MTB/RIF in HIV-infected patients with SNTB for the diagnosis of TB and RIF-resistance was low. Further studies are required to evaluate the results of Xpert MTB/RIF assay in HIV-infected patients with SNTB and the role of Xpert repetition on the same specimens.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
Diagnostic Tests, Routine*
Drug Resistance, Bacterial
Female
HIV Infections / complications*
HIV Infections / diagnosis*
Humans
Male
Microbial Sensitivity Tests
Reference Standards
Tuberculosis, Pulmonary / complications*
Tuberculosis, Pulmonary / diagnosis*

Grants and funding

Mr. Cuong got grants from the VIETNAM ADMINISTRATION OF HIV/AIDS CONTROL (grant number: 0095, 2013). URL: http://vaac.gov.vn/en-us The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.