REDUCED SENSITIVITY OF TUBERCULOSIS SERODIAGNOSIS IN PATIENTS WITH AIDS IN UGANDA

Setting: The diagnostic utility of serodiagnosis of tuberculosis in HI V-infected persons was studied in Kampala, Uganda. Objective: This stu d was undertaken to evaluate the utility of a recently described serol ogic assay for the diagnosis of tuberculosis in HIV-infected patients. Design: The study was undertaken as a cross-sectional survey of 349 s ubjects, including human immunodeficiency virus-infected and uninfecte d patients with tuberculosis and control subjects. Serum from each sub ject was assayed by enzyme-linked immunosorbent assay (ELISA) for IgG antibody to the 30 000 dalton antigen of Mycobacterium tuberculosis. R esults: Test sensitivity dropped from 0.62 in non HIV-infected tubercu lous patients to 0.28 in HIV-infected patients. Conclusions: ELISA ser odiagnosis of tuberculosis may have a markedly decreased utility in po pulations where HIV infection is prevalent.