Albuquerque Yvana Maria Maia de, Lima Ana Luiza Magalhães de Andrade, Lins Ana Kelly, Magalhães Marcelo, Magalhães Vera
Tropical Medicine Post-graduation, Universidade Federal de Pernambuco, RecifePE, Brazil, Tropical Medicine Post-graduation, Universidade Federal de Pernambuco, Recife-PE, Brazil.
Faculdade Pernambucana de Saúde, RecifePE, Brazil, Faculdade Pernambucana de Saúde, Recife-PE, Brazil.
Rev Inst Med Trop Sao Paulo. 2014 Mar-Apr;56(2):139-42. doi: 10.1590/S0036-46652014000200009.
To assess quantitative real-time polymerase chain reaction (q-PCR) for the sputum smear diagnosis of pulmonary tuberculosis (PTB) in patients living with HIV/AIDS with a clinical suspicion of PTB.
This is a prospective study to assess the accuracy of a diagnostic test, conducted on 140 sputum specimens from 140 patients living with HIV/AIDS with a clinical suspicion of PTB, attended at two referral hospitals for people living with HIV/AIDS in the city of Recife, Pernambuco, Brazil. A Löwenstein-Jensen medium culture and 7H9 broth were used as gold standard.
Of the 140 sputum samples, 47 (33.6%) were positive with the gold standard. q-PCR was positive in 42 (30%) of the 140 patients. Only one (0.71%) did not correspond to the culture. The sensitivity, specificity and accuracy of the q-PCR were 87.2%, 98.9% and 95% respectively. In 39 (93%) of the 42 q-PCR positive cases, the CT (threshold cycle) was equal to or less than 37.
q-PCR performed on sputum smears from patients living with HIV/AIDS demonstrated satisfactory sensitivity, specificity and accuracy, and may therefore be recommended as a method for diagnosing PTB.
评估实时定量聚合酶链反应（q-PCR）用于对临床怀疑患有肺结核（PTB）的HIV/AIDS患者痰液涂片进行肺结核诊断的效果。
这是一项评估诊断试验准确性的前瞻性研究，对来自巴西伯南布哥州累西腓市两家HIV/AIDS转诊医院的140例临床怀疑患有PTB的HIV/AIDS患者的140份痰液标本进行检测。采用罗氏培养基培养和7H9肉汤培养作为金标准。
140份痰液样本中，47份（33.6%）经金标准检测呈阳性。140例患者中，42例（30%）q-PCR检测呈阳性。仅1例（0.71%）与培养结果不符。q-PCR的敏感性、特异性和准确性分别为87.2%、98.9%和95%。在42例q-PCR阳性病例中，39例（93%）的CT（阈值循环数）等于或小于37。
对HIV/AIDS患者痰液涂片进行q-PCR检测显示出令人满意的敏感性、特异性和准确性，因此可推荐作为诊断PTB的一种方法。
