Point-of-care C-reactive protein testing to facilitate implementation of isoniazid preventive therapy for people living with HIV

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Christina YoonAdithya Cattamanchi

Abstract

Symptom-based tuberculosis screening identifies less than one-third of eligible HIV-infected patients as candidates for isoniazid preventive therapy (IPT). We evaluated whether testing for C-reactive protein (CRP) improves patient selection for IPT. We measured CRP levels (normal <10 mg/L) using a point-of-care (POC) assay on stored serum samples from HIV-infected Ugandan adults initiating antiretroviral therapy. We assessed diagnostic accuracy in reference to baseline tuberculosis status adjudicated by an expert committee and calculated net reclassification improvement to quantify the incremental discriminatory benefit of POC-CRP in determining IPT eligibility compared to the World Health Organization (WHO) symptom screen. Of 201 patients (median CD4 cell count, 137 cells/μL; interquartile range, 83-206), 5 (2.5%) had tuberculosis. Compared to the WHO symptom screen, POC-CRP had similar sensitivity (100% vs. 80%, P = 0.30) but greater specificity (21% vs. 87%, P < 0.0001) for tuberculosis. If based on the WHO symptom screen, no patients with tuberculosis but only 42 of 196 patients without tuberculosis would have been considered IPT eligible. If POC-CRP were used instead, 1 patient with tuberculosis (reclassification of cases,...Continue Reading

Associated Clinical Trials

References

Nov 25, 1981·Clinica Chimica Acta; International Journal of Clinical Chemistry·B ShineM B Pepys
Mar 31, 2001·Transactions of the Royal Society of Tropical Medicine and Hygiene·S D LawnR B Lal
Jan 7, 2003·Annals of Internal Medicine·Patrick M BossuytUNKNOWN Standards for Reporting of Diagnostic Accuracy
Jun 12, 2003·The European Respiratory Journal·A PolzinH Lode
Apr 2, 2005·The European Respiratory Journal·G K SchleicherC Feldman
Apr 10, 2010·International Journal of STD & AIDS·E K SageR F Miller
Feb 10, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Stephen D LawnRobin Wood
Jun 14, 2012·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Sheri D WeiserDavid R Bangsberg
Apr 12, 2013·The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·S D LawnR Wood

❮ Previous
Next ❯

Citations

Apr 2, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Rupak ShivakotiUNKNOWN New Work Concept Sheet 319 and The Prospective Evaluation of Antiretrovirals in Resource-Limited Settings Study Team
Oct 7, 2016·AIDS Research and Therapy·Narendran GopalanSrikanth Tripathy
Nov 22, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jayant V RajanAdithya Cattamanchi
Oct 29, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Fred C SemitalaChristina Yoon
Nov 27, 2018·Open Forum Infectious Diseases·Douglas WilsonGary Maartens
Apr 1, 2020·Indian Journal of Clinical Biochemistry : IJCB·Bineeta KashyapN P Singh
Mar 17, 2021·Expert Review of Anti-infective Therapy·Lara FusaniLuisa Galli

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antitubercular Agents (ASM)

Antitubercular agents are pharmacologic agents for treatment of tuberculosis. Discover the latest research on antitubercular agents here.

Antitubercular Agents

Antitubercular agents are pharmacologic agents for treatment of tuberculosis. Discover the latest research on antitubercular agents here.

Related Papers

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
Valeria SaraceniBetina Durovni
The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
V F GomesPer Gustafson
The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
S ZaehA Tenna
The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
R K ShresthaJ M Blandford
© 2021 Meta ULC. All rights reserved