Diagnostic and prognostic value of serum C-reactive protein for screening for HIV-associated tuberculosis

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
Stephen D LawnRobin Wood

Abstract

Rapid means of ruling in or ruling out tuberculosis (TB) would permit more efficient management of patients starting antiretroviral treatment (ART). To assess the diagnostic and prognostic utility of C-reactive protein (CRP) among patients being screened for TB before ART in a South African ART clinic. Patients were microbiologically screened for TB regardless of symptoms; serum CRP was measured, and mortality at 3 months was assessed. Among 496 patients (median CD4 count 171 cells/l), culture-positive TB was diagnosed in 81 (16.3%). CRP concentrations were much higher among TB cases (median 57.8 mg/l, IQR 20.0202.7) than in those without TB (6.4 mg/l, IQR 2.121.8, P < 0.001). Very low (<1.5 mg/l) CRP concentrations excluded TB (100% negative predictive value), whereas very high concentrations (>400 mg/l) were strongly predictive of TB (100% positive predictive value). However, these thresholds encompassed only 14.3% and 2.0%, respectively, of all patients screened and identified only 12.3% of TB cases. CRP concentrations ≥50 mg/l were associated with poor prognostic characteristics, higher mycobacterial load, disseminated disease and greater mortality risk. CRP concentrations identified groups of patients with very high or ver...Continue Reading

Associated Clinical Trials

Citations

Dec 19, 2013·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Christina YoonAdithya Cattamanchi
Nov 10, 2013·The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·Christina YoonAdithya Cattamanchi
Apr 15, 2004·Medical Hypotheses·L Broxmeyer
Oct 7, 2016·AIDS Research and Therapy·Narendran GopalanSrikanth Tripathy
Oct 29, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Fred C SemitalaChristina Yoon
Jan 14, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Fausto CiccacciMaria Cristina Marazzi
Mar 17, 2021·Expert Review of Anti-infective Therapy·Lara FusaniLuisa Galli

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