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Tuberculosis diagnostics to reduce HIV-associated mortality: Barnett Christie Lecture 2020

Gupta-Wright, A; (2022) Tuberculosis diagnostics to reduce HIV-associated mortality: Barnett Christie Lecture 2020. Clinical Infection in Practice , 15 , Article 100152. 10.1016/j.clinpr.2022.100152. Green open access

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Abstract

Tuberculosis (TB) was declared a global emergency in 1993 by the World health Organization (WHO), with global and African regional TB incidence rates driven by the HIV epidemic. Much of this burden lay in health facilities in sub-Saharan Africa, with post-mortem studies showing almost half of fatal TB goes undiagnosed, reflecting a failure in the approach to TB diagnostics. HIV-associated TB is often under the clinical radar, and this paper describes strategies to improve TB diagnostics to expedite treatment, reduce the amount of undiagnosed disease and ultimately reduce mortality. Through studies assessing the diagnostic accuracy and yield of new, rapid TB diagnostics, including the Xpert MTB/RIF nucleic acid amplification and urinary lipoarabinomannan (LAM) lateral flow assays, and clinical trials to measure impact on mortality and clinically relevant outcomes, this paper describes how TB diagnostics can reduce HIV-associated morbidity and mortality. With improved TB diagnostics in the pipeline, the future of urine-LAM assays for TB are also discussed.

Type: Article
Title: Tuberculosis diagnostics to reduce HIV-associated mortality: Barnett Christie Lecture 2020
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.clinpr.2022.100152
Publisher version: https://doi.org/10.1016/j.clinpr.2022.100152
Language: English
Additional information: © 2022 The Author. Published by Elsevier Ltd on behalf of British Infection Association under a Creative Commons license (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: HIV, TB, Diagnostics, Mortality
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10153983
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