Featured Research

from universities, journals, and other organizations

Test may improve diagnosis of tuberculous meningitis in HIV-infected individuals

Date:
October 22, 2013
Source:
Public Library of Science
Summary:
Tuberculous meningitis is a serious and often fatal illness that is difficult to diagnose particularly in resource-poor areas, and is especially common in individuals infected with HIV. Now, a new DNA test is available that can be used in resource-poor settings and is generally used to detect TB in sputum, to detect TB DNA in cerebrospinal fluid.

Tuberculous meningitis (TBM) is a serious and often fatal illness that is difficult to diagnose particularly in resource-poor areas and is especially common in individuals infected with HIV. In this week's PLOS Medicine, Vinod B. Patel and colleagues from University of KwaZulu-Natal, Durban, South Africa, and University of Cape Town, South Africa, used Xpert MTB/RIF, a newly available DNA test that can be used in resource-poor settings and is generally used to detect TB in sputum, to detect TB DNA in cerebrospinal fluid. They performed the study in 204 South African patients with a meningeal-like illness, of whom 87% were HIV-infected.

In this cohort, using a gold standard of positive culture or traditional polymerase chain reaction to determine who truly had TBM, 59 individuals had definite TBM, 64 had probable TBM, and 81 did not have TBM. Overall sensitivity of the Xpert MTB/RIF test (percentage of individuals correctly identified as having TBM) was 62% (95% confidence int ervals, 48%-75%) and specificity of the test (percentage of individuals correctly identified as not having TBM) was 95% (95% confidence intervals, 87%-99%). The sensitivity of Xpert MTB/RIF was significantly better than that of smear microscopy (62% versus 12%; p = 0.001) and sensitivity improved to 82% (95% confidence intervals 62%-94%) when the test was performed after centrifuging the sample. The test did not perform well in the few individuals who were not HIV-infected. The authors conclude, "Xpert MTB/RIF may be a good rule-in test for the diagnosis of TBM in HIV-infected individuals from a tuberculosis-endemic setting, particularly when a centrifuged CSF pellet is used. Further studies are required to confirm these findings in different settings."

In a related Perspective, David Boulware (uninvolved in the study) of the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, states "Tuberculous meningitis (TBM) is characterized by copious cerebrospinal fluid (CSF) inflammation and yet few Mycobacterium tuberculosis. This combination creates a disease that is notoriously difficult to definitively diagnose…Xpert MTB/RIF appears to be a highly useful test to "rule in" the diagnosis of TBM, yet the clinical acumen of physicians remains a necessity for the wise use of any new diagnostic test. Careful application of these new diagnostic tools should improve clinicians' ability to deliver timely, cost-effective care to patients with suspected TBM throughout the world, an approach that future studies should systematically evaluate."


Story Source:

The above story is based on materials provided by Public Library of Science. Note: Materials may be edited for content and length.


Journal Reference:

  1. Vinod B. Patel, Grant Theron, Laura Lenders, Brian Matinyena, Cathy Connolly, Ravesh Singh, Yacoob Coovadia, Thumbi Ndung'u, Keertan Dheda. Diagnostic Accuracy of Quantitative PCR (Xpert MTB/RIF) for Tuberculous Meningitis in a High Burden Setting: A Prospective Study. PLoS Medicine, 2013; 10 (10): e1001536 DOI: 10.1371/journal.pmed.1001536

Cite This Page:

Public Library of Science. "Test may improve diagnosis of tuberculous meningitis in HIV-infected individuals." ScienceDaily. ScienceDaily, 22 October 2013. <www.sciencedaily.com/releases/2013/10/131022183246.htm>.
Public Library of Science. (2013, October 22). Test may improve diagnosis of tuberculous meningitis in HIV-infected individuals. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2013/10/131022183246.htm
Public Library of Science. "Test may improve diagnosis of tuberculous meningitis in HIV-infected individuals." ScienceDaily. www.sciencedaily.com/releases/2013/10/131022183246.htm (accessed July 25, 2014).

Share This




More Health & Medicine News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

AFP (July 24, 2014) A so-called drugs rehab 'clinic' is closed down in Pakistan after police find scores of ‘patients’ chained up alleging serial abuse. Duration 03:05 Video provided by AFP
Powered by NewsLook.com
Too Few Teens Receiving HPV Vaccination, CDC Says

Too Few Teens Receiving HPV Vaccination, CDC Says

Newsy (July 24, 2014) The Centers for Disease Control and Prevention is blaming doctors for the low number of children being vaccinated for HPV. Video provided by Newsy
Powered by NewsLook.com
New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile: iPhone Android Web
          Follow: Facebook Twitter Google+
          Subscribe: RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins