Conference Coverage

Hospital urine screening reduces TB deaths in HIV+ adults

 

Key clinical point: Adding urine screening for TB to sputum screening in hospitalized HIV+ patients can reduce risk for death from TB.

Major finding: Among patients with CD4 counts below 100/uL, the 56-day mortality rates was of 35.7% with sputum screening alone vs. 28.8% for combined urine and sputum screening.

Data source: Randomized pragmatic trial in 2,574 HIV+ hospitalized adults in Malawi and South Africa.

Disclosures: The study was funded by UK AID, the UK Medical Research Council, and the Wellcome Trust. Dr. Gupta-Wright reported having no conflicts of interest to disclose.

Source: Gupta-Wright A et al. CROI 2018, Abstract 38LB.


 

REPORTING FROM CROI

– 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

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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