Identification of HIV patients with active pulmonary tuberculosis using urine based polymerase chain reaction assay
- Antonio Acetia,
- Stefania Zanettib,
- Maria S Muraa,
- Leonardo A Sechib,
- Franco Turrinic,
- Franca Sabaa,
- Sergio Babudieria,
- Franca Mannuc,
- Giovanni Faddad
- aInstitute of Infectious Diseases, University of Sassari, 07100 Sassari, Italy, bDepartment of Biomedical Sciences, Section of Experimental and Clinical Microbiology, University of Sassari, Sassari, Italy, cDepartment of Genetics, Biology and Medical Chemistry, University of Turin, Turin, Italy, dInstitute of Microbiology, Faculty of Medicine, Catholic University, Rome, Italy
- Professor A Aceti.
- Received 29 May 1998
- Revision requested 12 August 1998
- Revised 10 November 1998
- Accepted 11 November 1998
BACKGROUND Despite the increased dissemination of tuberculosis among HIV infected patients, the diagnosis is difficult to establish. Traditional microbiological methods lack satisfactory sensitivity. We have developed a highly sensitive and specific nested polymerase chain reaction (PCR) capable of detecting Mycobacterium tuberculosis DNA in urine specimens and have used this test to examine urine specimens from HIV patients with active pulmonary tuberculosis.
METHODS Urine specimens from 13 HIV infected patients with microbiologically proven active pulmonary tuberculosis, 10 AIDS patients with non-tuberculous mycobacterial infection (documented by blood culture), 53 AIDS patients with no evidence of mycobacterial disease, and 80 healthy subjects (25 with positive skin test to purified protein derivative) were tested forM tuberculosis using PCR, acid fast staining (AFS), and culture.
RESULTS Of the urine specimens from patients with active tuberculosis, all tested positive by PCR, two by culture, and none by AFS. No reactivity was observed in urine specimens from patients with non-tuberculous mycobacterial infection. Of the 53 AIDS patients without mycobacterial infection, one had a positive urine PCR. Normal subjects were all negative.
CONCLUSIONS Urine based nested PCR for M tuberculosis may be a useful test for identifying HIV patients with pulmonary tuberculosis.