A new predictive model for an improved respiratory isolation strategy in HIV-infected patients with PTB.

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2014-07

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Abstract

Setting

Luigi Sacco Hospital, Milan, Italy, 1 January 2000-31 December 2010.

Objectives

To develop a predictive score for identifying human immunodeficiency virus (HIV) infected patients with pulmonary tuberculosis (PTB).

Design

Retrospective study based on the medical charts of HIV-infected patients admitted consecutively on presumption of PTB. Patients with culture-positive TB were included in the TB group. Culture-negative subjects formed the non-TB group. Risk factors for PTB were identified and a predictive model was developed. The diagnostic test accuracy of the derived score and that of previously developed scores were analysed.

Results

A total of 65 patients were included in the TB group and 505 subjects in the non-TB group. An eight-variable model (age, origin, alcohol use, respiratory rate, weight loss, haemoglobin, white blood cell count, typical chest X-ray) was derived. When compared with the different scores, this model showed the greatest area under the receiver operating characteristic curve (0.880). This score was the only one to present a negative likelihood ratio of <0.2, which is the threshold for giving strong diagnostic evidence against TB.

Conclusions

This model may be useful in predicting PTB in HIV patients in low-endemic countries. A validation study is necessary.

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Journal article

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Subjects

Humans, Tuberculosis, Pulmonary, HIV Infections, Models, Statistical, Likelihood Functions, Risk Factors, Retrospective Studies, Predictive Value of Tests, ROC Curve, Adult, Italy, Female, Male

Citation

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https://hdl.handle.net/10161/29824

Rights

https://creativecommons.org/licenses/by-nc/4.0

Published Version (Please cite this version)

10.5588/ijtld.13.0588

Publication Info

Carugati, M, C Schiroli, F Zanini, N Vanoni, M Galli, F Adorni and F Franzetti (2014). A new predictive model for an improved respiratory isolation strategy in HIV-infected patients with PTB. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 18(7). pp. 831–836. 10.5588/ijtld.13.0588 Retrieved from https://hdl.handle.net/10161/29824.

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Carugati

Manuela Carugati

Associate Professor of Medicine

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