A new, clinically-based algorithm for the diagnosis of HIV in African tuberculosis patients: cross-sectional analysis from Mzuzu, Malawi

Citation
Pm. Kelly et al., A new, clinically-based algorithm for the diagnosis of HIV in African tuberculosis patients: cross-sectional analysis from Mzuzu, Malawi, INT J STD A, 10(4), 1999, pp. 231-236
Citations number
35
Categorie Soggetti
Clinical Immunolgy & Infectious Disease
Journal title
INTERNATIONAL JOURNAL OF STD & AIDS
ISSN journal
09564624 → ACNP
Volume
10
Issue
4
Year of publication
1999
Pages
231 - 236
Database
ISI
SICI code
0956-4624(199904)10:4<231:ANCAFT>2.0.ZU;2-2
Abstract
We aimed to create an improved, clinically-based algorithm for the diagnosi s of HIV in tuberculosis (TB) patients. Cross-sectional analysis was perfor med on data from adult TB patients consecutively diagnosed at a Malawian di strict level hospital. Of 225 patients, 187 with valid HIV results were inc luded in the study. Sixty-seven per cent were HIV seropositive. Urban addre ss, history of skin rash and sexually transmitted diseases (STDs) and, on e xamination, oral candidiasis and lymphadenopathy, were associated with I-W co-infection. Using these clinical characteristics, a case definition for H IV was constructed. The Mzuzu clinical case definition was highly sensitive (86%). The area under the receiver operating characteristic (ROC) curve wa s 0.81, significantly larger than existing World Health Organization (WHO) clinical case definitions. The Mzuzu definition is proposed for further eva luation in settings where HIV serological testing is not readily available.