Can TB Diagnosis Be Improved in Persons Living with HIV in Africa?

Decreasing tuberculosis (TB)-related mortality among people living with HIV (PLWH) is urgently needed. Tuberculosis diagnosis continues to be suboptimal, and many patients die before being diagnosed. In 2015, the World Health Organization endorsed the urine lipoarabinomannan assay (Alere Determine TB-LAM) for use in adults with HIV admitted to the hospital with signs and symptoms of TB and a CD4 count <100 cells/µL or severe illness. In this study, investigators in Malawi and South Africa assessed whether urine-based TB-LAM screening in PLWH improved TB outcomes. During a 2-year period, 4788 HIV-positive adults admitted to the hospital were screened for eligibility and about 2600 randomized (1300 to standard of care and 1300 to the interven…