Performance of Tuberculosis Molecular Bacterial Load Assay Compared to Alere TB-LAM in Urine of Pulmonary Tuberculosis Patients with HIV Co-Infections

• Published in: International journal of molecular sciences Vol. 24; no. 4; p. 3715
• Main Authors: Mapamba, Daniel Adon, Sauli, Elingarami, Lalashowi, Julieth, Buza, Joram, John, Joseph, Mwaisango, Zawadi, Tarmo, Peter, Sabi, Issa, Rachow, Andrea, Ntinginya, Nyanda Elias, Mtafya, Bariki
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.02.2023; MDPI
• Subjects: Adult; Antiretroviral therapy; Bacterial Load; CD4 antigen; Cell culture; Coinfection; Comparative analysis; Experiments; Female; Health aspects; HIV; HIV (Viruses); HIV Infections - complications; HIV Infections - diagnosis; HIV patients; HIV testing; Human immunodeficiency virus; Humans; Infections; Lipopolysaccharides - analysis; Male; Microscopy; Mycobacterium tuberculosis; Patients; Sensitivity and Specificity; Sputum; Sputum - microbiology; TB-LAM; TB-lipoarabinomannan; TB-MBLA; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis, Pulmonary - diagnosis; tuberculosis-molecular bacterial load assay; Urine; Germany; Tanzania; TB-MBLA; tuberculosis-molecular bacterial load assay; HIV; TB-lipoarabinomannan; urine; TB-LAM; human immunodeficiency virus
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms24043715

Alternative tools are needed to improve the detection of ( ) in HIV co-infections. We evaluated the utility of Tuberculosis Molecular Bacterial Load Assay (TB-MBLA) compared to lipoarabinomannan (LAM) to detect in urine. Sputum Xpert MTB/RIF-positive patients were consented to provide urine at baseline, weeks 2, 8, 16, and 24 of treatment for TB-MBLA, culture, and LAM. Results were compared with sputum cultures and microscopy. Initial H37Rv spiking experiments were performed to validate the tests. A total of 63 urine samples from 47 patients were analyzed. The median age (IQR) was 38 (30-41) years; 25 (53.2%) were male, 3 (6.5%) had urine for all visits, 45 (95.7%) were HIV positive, of whom 18 (40%) had CD4 cell counts below 200 cells/µL, and 33 (73.3%) were on ART at enrollment. Overall urine LAM positivity was 14.3% compared to 4.8% with TB-MBLA. Culture and microscopy of their sputum counterparts were positive in 20.6% and 12.7% of patients, respectively. Of the three patients with urine and sputum at baseline, one (33.33%) had urine TB-MBLA and LAM positive compared to 100% with sputum MGIT culture positive. Spearman's rank correction coefficient (r) between TB-MBLA and MGIT was -0.85 and 0.89 with a solid culture, > 0.05. TB-MBLA has the promising potential to improve detection in urine of HIV-co-infected patients and complement current TB diagnostics.