Open AccessUrine lipoarabinomannan (LAM) and antimicrobial usage in seriously-ill HIV-infected patients with sputum smear-negative pulmonary tuberculosis
Author(s) -
Thuli Mthiyane,
Jonny Peter,
Jenny Allen,
Cathy Connolly,
Malika Davids,
Roxana Rustomjee,
Timothy H. Holtz,
Lesibana Anthony Malinga,
Keertan Dheda
Publication year - 2019
Publication title -
journal of thoracic disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.682
H-Index - 60
eISSN - 2077-6624
pISSN - 2072-1439
DOI - 10.21037/jtd.2019.07.69
Subject(s) - medicine , lipoarabinomannan , sputum , interquartile range , urine , sputum culture , tuberculosis , mycobacterium tuberculosis , gastroenterology , pathology
Based on current WHO guidelines, hospitalized tuberculosis (TB) and HIV co-infected patients with CD4 count <100 cells/mm 3 who are urine lipoarabinomannan (LAM) positive should be initiated on TB treatment. This recommendation is conditional, and data are limited in sputum smear-negative patients from TB endemic countries where the LAM test is largely inaccessible. Other potential benefits of LAM, including reduction in antibiotic usage have, hitherto, not been explored.