The Efficiency of TB LAM Antigen Test to Xpert MTB/RIF Ultra Test for the Diagnosis of Tuberculous Pericarditis Using Pericardial Fluid Samples

Medical considerations for early diagnosis of tuberculous pericarditis (TBP) include Xpert MTB/RIF Ultra and TB lipoarabinomannan (LAM) antigen (Ag) tests, with immunological status influencing the performance of the latter. An evaluation of the efficiency of Xpert MTB/RIF Ultra and TB LAM Ag in det...

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Bibliographic Details
Published in:Pathogens (Basel) 2023-09, Vol.12 (9), p.1175
Main Authors: Alomatu, Samuel, Vasaikar, Sandeep, Thomas, Kandathil, Dubula, Thozama, Moeketsi, Khulile
Format: Article
Language:English
Subjects:
Antigens
Caustic soda
Diagnosis
extrapulmonary tuberculosis
HIV
Human immunodeficiency virus
Immune system
Immunology
Infections
Laboratories
Likelihood ratio
Pathogens
Patients
pericardial fluid
Pericarditis
RNA polymerase
Sensitivity
TB LAM Ag
Testing
Tuberculosis
tuberculous pericarditis
Xpert MTB/RIF Ultra
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Summary:Medical considerations for early diagnosis of tuberculous pericarditis (TBP) include Xpert MTB/RIF Ultra and TB lipoarabinomannan (LAM) antigen (Ag) tests, with immunological status influencing the performance of the latter. An evaluation of the efficiency of Xpert MTB/RIF Ultra and TB LAM Ag in detecting TBP was conducted using pericardial fluid samples from 46 patients with suspected TBP. Fifteen patients (34.1%) were diagnosed with TBP according to culture results. TB LAM Ag’s sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were 33.3%, 100%, 100%, 74.4%, 0, and 0.67, respectively. The sensitivity, specificity, PLR, NLR, PPV, and NPV of Xpert MTB/RIF Ultra were 80%, 93.1%, 11.6, 0.21, 85.7%, and 90%, respectively. There was an association observed between a positive TB LAM Ag test and HIV status. When compared to the Xpert MTB/RIF Ultra test, TB LAM Ag has lower accuracy for the detection of microbiologically proven tuberculous pericarditis, yet its usage in HIV-positive populations may be worth exploring. The TB LAM Ag assay is not the best first-line test for the diagnosis of tuberculous pericarditis, and it should be used in conjunction with other diagnostic tests.
ISSN:2076-0817
2076-0817
DOI:10.3390/pathogens12091175