HIV Infections, Tuberculosis
Conditions
Keywords
Pulmonary Tuberculosis, Myobacterium Infections
Brief summary
An estimated 3 million HIV-infected individuals will enter programs for antiretroviral (ARV) treatment in the coming year, with projected rates of requirement for ARV therapy extending to more than 10 million in sub-Saharan Africa, southeastern Asia, and Latin America in the coming decade. In these settings, Tuberculosis (TB) is an endemic infection in the population, and an estimated 30-60% of adults have been infected with TB, the leading opportunistic infection associated with HIV infection. The purpose of this study is to construct a standardized diagnostic evaluation (SDE) for TB that provides an increase in identification of participants with active pulmonary TB, without sacrificing specificity.
Detailed description
Well developed TB diagnostic testing, contact tracing, and treatment programs are key parts of the public health and health care infrastructure in many countries where HIV infection has resulted in a 3- to 10-fold increase in clinical TB, accompanied by increasing HIV prevalence. The primary purpose of this study is to construct a standardized diagnostic evaluation (SDE) for TB that provides an increase in identification of participants with active pulmonary TB, without sacrificing specificity. This observational study will include participants who are HIV-infected and TB-uninfected and not receiving ARV therapy. The duration of this trial will last between 1 and 14 days. Screening and study entry may occur at the same visit. All evaluations must be performed within 14 days after the participant is registered. Medical and medication history, physical exam, oral examination and swab, chest x-ray, sputum and blood collection, and documentation of PPD/TST (if available) will occur within this 14-day period.
Interventions
OTHERStandardized diagnostic evaluation
Participants will undergo a diagnostic evaluation for TB at study entry
Sponsors
National Institute of Allergy and Infectious Diseases (NIAID)
National Institute of Dental and Craniofacial Research (NIDCR)
Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
13 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* HIV-infected
Exclusion criteria
* Receipt of ART within 90 days prior to study entry * Diagnosis of active TB (pulmonary or extrapulmonary) within 90 days prior to study entry * Receipt of 7 or more cumulative days of certain medications within 90 days prior to study entry. More information on this criterion can be found in the protocol.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Effectiveness in creating a standard diagnostic evaluation for identification of participants with active pulmonary TB | Throughout study |
Secondary
| Measure | Time frame |
|---|---|
| Rates of TB drug resistance | Throughout study |
| Feasibility and incremental benefits of diagnostic and screening evaluations over a range of CD4 cell counts | Throughout study |
| Prevalence of TB in symptomatic and asymptomatic individuals | Throughout study |
| Significance of investigational serologic assay when added to sputum acid-fast bacilli (AFB) smears when identifying participants with active TB compared to AFB smears alone | Throughout study |
| Storage of samples for future diagnostic and pathogenesis studies of mycobacterial, virologic, and immunologic factors | Throughout study |
| Value of oral candidiasis as a predictor of TB | Throughout study |
Countries
Botswana, Brazil, India, Malawi, Peru, South Africa, Zimbabwe
Outcome results
None listed