Urine-Based Tuberculosis Test in Hospitalized HIV-Positive Patients

Tuberculosis remains the leading cause of death in patients who are coinfected with HIV. Immunocompromised patients may have extrapulmonary or paucibacillary tuberculosis, which makes diagnosis with the current routine diagnostic tests challenging. To test the effect of a urine-based tuberculosis test on mortality in HIV coinfected patients, researchers conducted a clinical trial in 2528 HIV-positive hospitalized patients in South Africa, Tanzania, Zambia, and Zimbabwe who were randomized to usual testing (smear microscopy, Xpert-MTB/RIF, and sputum culture) with or without a rapid, low-cost, urine-based point-of-care Alere Determine TB lipoarabinomannan (LAM) Ag test assay, followed by antituberculosis treatment in patients who tested posi…