Performance of Combination of Symptoms, Chest x-rays and MGIT 960 Culture for Diagnosis of Pulmonary Tuberculosis in HIV Patients

Abstract

Introduction. The diagnosis of pulmonary tuberculosis in HIV patients remains a clinical challenge for various reason. The clinical feature of pulmonary tuberculosis in HIV patients is atypical and incomplete. This may cause under or overdiagnosis, which consequently contribute to the higher observed death rate in HIV population with the pulmonary tuberculosis. This study aims to identify factors related to the diagnosis of pulmonary tuberculosis in the HIV patient and contribution of MGIT 960 culture. Methods. A cross-sectional study was conducted among HIV patients suspected of having pulmonary tuberculosis from Oktober 2011 to April 2012. The association clinical features (cough, weight loss, fever) and radiologic examination with pulmonary tuberculosis (Lowenstein Jensen culture) was analyzed with logistic regression. Each factors contribution to diagnosis of pulmonary tuberculosis was determined. The performance of MGIT 960 culture was assed with ROC and AUC. Statistical analysis was conducted using SPSS version 16.0. Results. Among total of 100 subject, 30 were confirmed of having tuberculosis. Most of patient were male (63%). The final model of multiple logistics regression analysis revealed two factors associated with pulmonary tuberculosis: fever and weight loss. Abnormalities of chest x-rays was proved unrelated with diagnosis of tuberculosis. The AUC for combination of clinical manifestation was 71% with the addition of MGIT 960 culture, the AUC became 95.7%. Conclusions. Factors related with diagnosis of tuberculosis in HIV patients were fever and weight loss. Mycobacteria Growth Indicator Tube (MGIT) 960 culture would increase tuberculosis diagnosing in HIV patients.

Keywords

• HIV
• MGIT 960 culture
• Tuberculosis