RESULTS OF TESTING OF TUBERCULOSIS BIOMARKER LIPOARABOMANNAN (LAM) IN HOSPITALIZED TUBERCULOSIS PATIENTS

Abstract

The aim of the study to evaluate the expediency of detection of LAM-antigen in urine for the diagnostics of tuberculosis (TB).

Materials and methods. The urine LAM antigen detection was performed with the help of the Alere Determine TB LAM Ag recommended for TB diagnostics in HIV-positive patients. Urine samples of 88 adult patients were examined. Diagnosis of active TB was previously established in 77 patients, including 73 pulmonary TB (6 of them in combination with HIV infection).

Results and discussion. Positive LAM test results were obtained in 11 of 77 (14.3 %) patients with active TB, all of them from the group with pulmonary TB. Also the LAM-antigen was detected in 4 of 6 HIV-infected patients and in 7 of 67 (10.4 %) HIV-negative. In two cases of HIV-infected women the LAM-antigen detection served as the confirmation of active TB associated with negative results of microscopic and molecular genetic investigations.

In all 7 HIV-negative people with positive LAM-test results severe forms of pulmonary TB with comorbidities that caused immunosuppression were diagnosed.

Conclusions. Because of the low sensitivity of the urine LAM antigen detection possibly the application of the test is limited to some cases in HIV-positive individuals that didn’t receive confirmation of TB by other methods. It is assumed that number of LAM-test positive results may increase in immunodeficient conditions other than HIV infection.