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.
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.
Study Type
OBSERVATIONAL
Enrollment
801
Participants will undergo a diagnostic evaluation for TB at study entry
Gaborone Prevention/Treatment Trials CRS
Gaborone, Botswana
Molepolole Prevention/Treatment Trials CRS (Molepolole PTT CRS)
Molepolole, Botswana
Instituto de Pesquisa Clinica Evandro Chagas (IPEC) CRS
Manguinhos, Rio de Janeiro, Brazil
BJ Medical College CRS
Pune, Maharashtra, India
NARI Pune CRS
Pune, Maharashtra, India
University of North Carolina Lilongwe CRS
Lilongwe, Malawi
San Miguel CRS
San Miguel, Lima region, Peru
Asociacion Civil Impacta Salud y Educacion - Miraflores, CRS
Lima, Peru
Soweto ACTG CRS
Johannesburg, Gauteng, South Africa
Wits HIV CRS
Johannesburg, Gauteng, South Africa
...and 3 more locations
Effectiveness in creating a standard diagnostic evaluation for identification of participants with active pulmonary TB
Time frame: Throughout study
Prevalence of TB in symptomatic and asymptomatic individuals
Time frame: Throughout study
Rates of TB drug resistance
Time frame: Throughout study
Feasibility and incremental benefits of diagnostic and screening evaluations over a range of CD4 cell counts
Time frame: Throughout study
Value of oral candidiasis as a predictor of TB
Time frame: 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
Time frame: Throughout study
Storage of samples for future diagnostic and pathogenesis studies of mycobacterial, virologic, and immunologic factors
Time frame: Throughout study
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