Performance of Xpert MTB/RIF by Using Gastric Lavage Sample in The Diagnosis of Pulmonary Tuberculosis in HIV Patients with Suspected Pulmonary Tuberculosis
Introduction. Xpert MTB/RIF test on gastric lavage sample may improve pulmonary tuberculosis (TB) case finding, but its performance as a diagnostic test for pulmonary TB in HIV-infected adults patients has not been studied widely, including in Indonesia. This study aims to determine the performance...
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Department of Internal Medicine, Faculty of Medicine Universitas Indonesia
2018-03-01
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| Series: | Jurnal Penyakit Dalam Indonesia |
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| Online Access: | http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/172/141 |
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| author | Manuel Lamberto Willem Mboeik Ceva Wicaksono Pitoyo Teguh Harjono Karjadi Anis Karuniawati Esthika Dewiasty |
| author_facet | Manuel Lamberto Willem Mboeik Ceva Wicaksono Pitoyo Teguh Harjono Karjadi Anis Karuniawati Esthika Dewiasty |
| author_sort | Manuel Lamberto Willem Mboeik |
| collection | DOAJ |
| description | Introduction. Xpert MTB/RIF test on gastric lavage sample may improve pulmonary tuberculosis (TB) case finding, but its performance as a diagnostic test for pulmonary TB in HIV-infected adults patients has not been studied widely, including in Indonesia. This study aims to determine the performance of the Xpert MTB/RIF test in diagnosing pulmonary tuberculosis among HIV-infected adult patients with suspected pulmonary tuberculosis by using gastric lavage sample.
Method. A cross-sectional study was conducted on adult HIV-infected patients with suspected pulmonary tuberculosis in Cipto Mangunkusumo hospital Jakarta between February 2016 and June 2017. Gastric lavage sample and sputum sample collection were performed for Xpert MTB/RIF test and acif fast bacilli (AFB) smear examination.
Results. Among total of 117 subjects, 81 (69,2%) subjects were unable to expectorate sputum. M tuberculosis was detected on Xpert MTB/RIF using gastric lavage samples in 34 (29,1%) subjects, AFB in 4 of 36 sputum samples and 2 of 117 gastric lavage samples. The drug sensitivity test on all 34 Xpert MTB/RIF positive subjects showed no rifampicin resistance. Fifty-one (43.6%) subjects were diagnosed as clinical pulmonary tuberculosis, 26 subjects among them were positive on Xpert MTB/ RIF assay, 4 subjects were smear sputum positive and 1 subject was gastric lavage smear positive. Using clinical diagnosis of pulmonary TB as gold standard, a single Xpert MTB/RIF assay using gastric lavage sample showed sensitivity of 50.98% (95% CI: 36.6-65.25), specificity 87.88% (95% CI: 77,1-94,62), positive predictive value 76,47% (95%CI: 61,67-86,78) and negative predictive value 69,88% (95% CI: 63,36-75.68).
Conclusion. Xpert MTB/RIF performed on gastric lavage samples showed sensitivity of 50.98% and specificity 87.88% in clinical diagnosis of pulmonary tuberculosis in HIV-positive patients with pulmonary tuberculosis. |
| format | Article |
| id | doaj-art-bc254fea34574c41b1a6b2b27f4daf71 |
| institution | OA Journals |
| issn | 2406-8969 2549-0621 |
| language | Indonesian |
| publishDate | 2018-03-01 |
| publisher | Department of Internal Medicine, Faculty of Medicine Universitas Indonesia |
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| series | Jurnal Penyakit Dalam Indonesia |
| spelling | doaj-art-bc254fea34574c41b1a6b2b27f4daf712025-08-20T02:01:09ZindDepartment of Internal Medicine, Faculty of Medicine Universitas IndonesiaJurnal Penyakit Dalam Indonesia2406-89692549-06212018-03-01512934http://dx.doi.org/10.7454/jpdi.v5i1.172Performance of Xpert MTB/RIF by Using Gastric Lavage Sample in The Diagnosis of Pulmonary Tuberculosis in HIV Patients with Suspected Pulmonary TuberculosisManuel Lamberto Willem Mboeik0Ceva Wicaksono Pitoyo1Teguh Harjono Karjadi2Anis Karuniawati3Esthika Dewiasty4Fakultas Kedokteran Universitas Indonesia Ciptomangunkusumo National General Hospital IndonesiaDivisi Respirologi dan Penyakit Kritis, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia – RSUPN Dr. Cipto Mangunkusumo, Jakarta Indonesia Divisi Alergi Imunologi Klinik, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia – RSUPN Dr. Cipto Mangunkusumo, Jakarta Indonesia Departemen Mikrobiologi Klinik, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia – RSUPN Dr. Cipto Mangunkusumo, Jakarta Indonesia Unit Epidemiologi Klinik, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia – RSUPN Dr. Cipto Mangunkusumo, Jakarta Indonesia Introduction. Xpert MTB/RIF test on gastric lavage sample may improve pulmonary tuberculosis (TB) case finding, but its performance as a diagnostic test for pulmonary TB in HIV-infected adults patients has not been studied widely, including in Indonesia. This study aims to determine the performance of the Xpert MTB/RIF test in diagnosing pulmonary tuberculosis among HIV-infected adult patients with suspected pulmonary tuberculosis by using gastric lavage sample. Method. A cross-sectional study was conducted on adult HIV-infected patients with suspected pulmonary tuberculosis in Cipto Mangunkusumo hospital Jakarta between February 2016 and June 2017. Gastric lavage sample and sputum sample collection were performed for Xpert MTB/RIF test and acif fast bacilli (AFB) smear examination. Results. Among total of 117 subjects, 81 (69,2%) subjects were unable to expectorate sputum. M tuberculosis was detected on Xpert MTB/RIF using gastric lavage samples in 34 (29,1%) subjects, AFB in 4 of 36 sputum samples and 2 of 117 gastric lavage samples. The drug sensitivity test on all 34 Xpert MTB/RIF positive subjects showed no rifampicin resistance. Fifty-one (43.6%) subjects were diagnosed as clinical pulmonary tuberculosis, 26 subjects among them were positive on Xpert MTB/ RIF assay, 4 subjects were smear sputum positive and 1 subject was gastric lavage smear positive. Using clinical diagnosis of pulmonary TB as gold standard, a single Xpert MTB/RIF assay using gastric lavage sample showed sensitivity of 50.98% (95% CI: 36.6-65.25), specificity 87.88% (95% CI: 77,1-94,62), positive predictive value 76,47% (95%CI: 61,67-86,78) and negative predictive value 69,88% (95% CI: 63,36-75.68). Conclusion. Xpert MTB/RIF performed on gastric lavage samples showed sensitivity of 50.98% and specificity 87.88% in clinical diagnosis of pulmonary tuberculosis in HIV-positive patients with pulmonary tuberculosis.http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/172/141AdultHIVGastric lavagePulmonary TBXpert MTB/RIF |
| spellingShingle | Manuel Lamberto Willem Mboeik Ceva Wicaksono Pitoyo Teguh Harjono Karjadi Anis Karuniawati Esthika Dewiasty Performance of Xpert MTB/RIF by Using Gastric Lavage Sample in The Diagnosis of Pulmonary Tuberculosis in HIV Patients with Suspected Pulmonary Tuberculosis Jurnal Penyakit Dalam Indonesia Adult HIV Gastric lavage Pulmonary TB Xpert MTB/RIF |
| title | Performance of Xpert MTB/RIF by Using Gastric Lavage Sample in The Diagnosis of Pulmonary Tuberculosis in HIV Patients with Suspected Pulmonary Tuberculosis |
| title_full | Performance of Xpert MTB/RIF by Using Gastric Lavage Sample in The Diagnosis of Pulmonary Tuberculosis in HIV Patients with Suspected Pulmonary Tuberculosis |
| title_fullStr | Performance of Xpert MTB/RIF by Using Gastric Lavage Sample in The Diagnosis of Pulmonary Tuberculosis in HIV Patients with Suspected Pulmonary Tuberculosis |
| title_full_unstemmed | Performance of Xpert MTB/RIF by Using Gastric Lavage Sample in The Diagnosis of Pulmonary Tuberculosis in HIV Patients with Suspected Pulmonary Tuberculosis |
| title_short | Performance of Xpert MTB/RIF by Using Gastric Lavage Sample in The Diagnosis of Pulmonary Tuberculosis in HIV Patients with Suspected Pulmonary Tuberculosis |
| title_sort | performance of xpert mtb rif by using gastric lavage sample in the diagnosis of pulmonary tuberculosis in hiv patients with suspected pulmonary tuberculosis |
| topic | Adult HIV Gastric lavage Pulmonary TB Xpert MTB/RIF |
| url | http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/172/141 |
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