ArticlePloS one2015
Is Urinary Lipoarabinomannan the Result of Renal Tuberculosis? Assessment of the Renal Histology in an Autopsy Cohort of Ugandan HIV-Infected Adults.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Parallel use of low-complexity automated nucleic acid amplification tests and lateral flow urine lipoarabinomannan assays to detect tuberculosis disease in adults and adolescents living with HIV.The Cochrane database of systematic reviews · 2025Pooled it
- Parallel use of low-complexity automated nucleic acid amplification tests and lateral flow urine lipoarabinomannan assays to detect tuberculosis disease in adults and adolescents living with HIV.The Cochrane database of systematic reviews · 2024Pooled it
- Pooled it
- Tuberculosis disease characteristics associated with mortality, severe morbidity and unsuccessful treatment in people living with HIV treated for tuberculosis - a secondary analysis of the ANRS 12300 Reflate TB2 trial.BMC infectious diseases · 2025Trial
- Trial
- Urinary lipoarabinomannan in individuals with sputum-negative pulmonary tuberculosis.The Indian journal of medical research · 2024Article
- Performance of Tuberculosis Molecular Bacterial Load Assay Compared to Alere TB-LAM in Urine of Pulmonary Tuberculosis Patients with HIV Co-Infections.International journal of molecular sciences · 2023Article
- Towards Accurate Point-of-Care Tests for Tuberculosis in Children.Pathogens (Basel, Switzerland) · 2022Review
- Diagnosing Tuberculosis: What Do New Technologies Allow Us to (Not) Do?Respiration; international review of thoracic diseases · 2022Review
- Fujifilm SILVAMP TB-LAM for the Diagnosis of Tuberculosis in Nigerian Adults.Journal of clinical medicine · 2021Article
- Diagnostic Performance of the Fujifilm SILVAMP TB-LAM in Children with Presumptive Tuberculosis.Journal of clinical medicine · 2021Article
- Clinical, radiological, and laboratory predictors of a positive urine lipoarabinomannan test in sputum-scarce and sputum-negative patients with HIV-associated tuberculosis in two Johannesburg hospitals.Southern African journal of HIV medicine · 2021Article
- Point-Of-Care Urine LAM Tests for Tuberculosis Diagnosis: A Status Update.Journal of clinical medicine · 2019Review
- Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in people living with HIV.The Cochrane database of systematic reviews · 2019Review
- Novel lipoarabinomannan point-of-care tuberculosis test for people with HIV: a diagnostic accuracy study.The Lancet. Infectious diseases · 2019Article
- Clinical, microbiologic, and immunologic determinants of mortality in hospitalized patients with HIV-associated tuberculosis: A prospective cohort study.PLoS medicine · 2019Observational
- Observational
- Biomarkers for tuberculosis: the case for lipoarabinomannan.ERJ open research · 2019Review
- Feasibility of using Determine TB-LAM to diagnose tuberculosis in HIV-positive patients in programmatic conditions: a multisite study.Global health action · 2019Article
- Article
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Authors and funding
9 authors at 5 institutions in 4 countries.
Funding
Abstract
objectiveThe detection of urinary lipoarabinomannan (LAM), a mycobacterial cell wall component, is used to diagnose tuberculosis (TB). How LAM enters the urine is not known. To investigate if urinary LAM-positivity is the result of renal TB infection we correlated the outcomes of urinary LAM-antigen testing to renal histology in an autopsy cohort of hospitalized, Ugandan, HIV-infected adults.
methodsWe performed a complete autopsy, including renal sampling, in HIV-infected adults that died during hospitalization after written informed consent was obtained from the next of kin. Urine was collected postmortem through post-mortem catheterisation or by bladder puncture and tested for LAM with both a lateral flow assay (LFA) and an ELISA assay. Two pathologists assessed the kidney histology. We correlated the LAM-assay results and the histology findings.
resultsOf the 13/36 (36%) patients with a positive urinary LAM ELISA and/or LFA, 8/13 (62%) had renal TB. The remaining 5 LAM-positive patients had disseminated TB without renal involvement. Of the 23 LAM-negative patients, 3 had disseminated TB without renal involvement. The remaining LAM-negative patients had no TB infection and died mostly of fungal and bacterial infections. LAM LFA had a sensitivity of 81% and specificity of 100% to diagnose TB at any location, and the LAM ELISA a sensitivity of 63% and a specificity of 100%. 54% (7/13) LAM LFA-positive patients were not on anti-TB treatment at the time of death.
conclusionRenal TB infection explained LAM-positivity in the majority of patients. Patients with disseminated TB without renal involvement can also be diagnosed with LAM. This suggests that other mechanisms that lead to urinary LAM-positivity exist in a minority of patients.
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