Use of a low-cost urine test to guide tuberculosis treatment significantly improved mortality in HIV-positive patients, based on data from a randomized, multicenter trial including 2,528 adults at 10 locations in Africa.
The test involved a urine-based, lateral flow, point-of-care, lipoarabinomannan assay (LAM), and no associated adverse events were reported in this study.
Mortality at 8 weeks after LAM was significantly lower among patients who received LAM-guided antituberculosis treatment (21%), compared with control patients (25%). The relative risk reduction with LAM was 17%, and use of LAM improved the time to treatment initiation at all study locations, the researchers noted.
“The implementation of LAM testing is likely to offer the greatest benefit in hospitals where diagnostic resources are most limited, and where patients often present with severe illness, advanced immunosuppression, and an inability to self-expectorate sputum,” wrote Jonny G. Peter, Ph.D., of the University of Cape Town, South Africa, and colleagues.
Read the full study in the Lancet (2016 Mar 9. doi: 10.1016/S0140-6736(15)01092-2).