Contribution of TB-LAM Urine Test to Tuberculosis Diagnosis in HIV-infected Adult Patients in Burkina Faso

Abstract

Aims: With the aim of improving the diagnosis of tuberculosis in patients living with HIV, we set out to evaluate the contribution of the TB-LAM urine test to the diagnosis of tuberculosis in PLWHA in Burkina Faso, in real life. Methodology: The study was conducted in the Infectious Diseases Departments of the Yalgado OUEDRAOGO (CHU-YO), Souro SANOU (CHU-SS) and Bogodogo (CHU-B) University Hospitals. These 03 centers are among the most important reference centers in Burkina Faso. This was a descriptive and analytical cross-sectional study with prospective data collection over 12 months, from January 1, 2023 to December 31, 2023, and involved PLWH inpatients and outpatients. Data were collected using the KoBoCollect v1.30.1 application and analyzed using STATA 16 software. Binary uni and multivariate logistic regression with a statistical significance level of 0.05 was used to identify associated factors. Results: A total of 113 patients were included in the study. The mean age was 43 ± 1.35 years, with a sex ratio of 0.85. The TB-LAM urine test was positive in 76 patients, for a positivity rate of 67.26%. The diagnosis of tuberculosis was confirmed by bacteriology in accordance with the national tuberculosis management protocol in 18/113 (15.93%) patients. Bacilloscopy and the Xpert test performed on all biological fluids, combined with the TB-LAM urine test, enabled the diagnosis of 81/113 (71.68%) patients in the study. Patients already on antiretroviral therapy (ORa=0.06 [0.06-0.73], p=0.02) were less likely to test positive for urinary TB-LAM, and those with unexplained asthenia (ORa=15.76 [1.19-20.66], p=0.03) were more likely to test positive. Conclusion: The TB-LAM urine test, combined with other tuberculosis diagnostic tools, increases the diagnostic yield of tuberculosis in PLWHA.