Evidence map›Paper›PMID 28911358›Full record

Observational studyThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2017

Performance of nested RT-PCR on CSF for tuberculous meningitis diagnosis in HIV-infected patients.

F A S Gualberto, M G Gonçalves, L O Fukasawa, A M Ramos Dos Santos, C T Sacchi, L H Harrison, D R Boulware, J E Vidal

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Xpert MTB/RIFThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

F A S GualbertoDepartamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, Centro de Imunologia, Instituto Adolfo Lutz, São Paulo, São Paulo, Brazil.
M G GonçalvesCentro de Imunologia, Instituto Adolfo Lutz, São Paulo, São Paulo, Brazil.
L O FukasawaCentro de Imunologia, Instituto Adolfo Lutz, São Paulo, São Paulo, Brazil.
A M Ramos Dos SantosDepartamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo.
C T SacchiCentro de Imunologia, Instituto Adolfo Lutz, São Paulo, São Paulo, Brazil.
L H HarrisonInfectious Diseases Epidemiology Research Unit, University of Pittsburgh, Pittsburgh, Pennsylvania.
D R BoulwareDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
J E VidalDepartamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Departamento de Neurologia, Instituto de Infectologia Emília Ribas, São Paulo, Laboratório de Investigação Médica 49, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.
Instituto Adolfo Lutz · BRUniversidade de São Paulo · BRUniversity of Minnesota · USUniversity of Pittsburgh · US

Funding

Improving Diagnostics and Neurocognitive Outcomes in HIV/AIDS-related MeningitisR01NS086312 · NINDS · UNIVERSITY OF MINNESOTA · PI David R Boulware, David Bisagaya Meya · 2013 to 2026
$8.3M
Real-Time PCR for Diagnosis of Culture-Negative Bacterial Meningitis in S?o PauloD43TW006592 · FIC · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI HARRISON, LEE H · 2004 to 2013
$1.7M
FIC NIH HHS D43 TW006592NINDS NIH HHS R01 NS086312
6 · The paper itself

Abstract

settingTimely diagnosis of tuberculous meningitis (TBM) in patients with human immunodeficiency virus (HIV) infection remains a challenge. Despite the current scale-up of the Xpert® MTB/RIF assay, other molecular diagnostic tools are necessary, particularly in referral centres in low- and middle-income countries without Xpert testing.

objectiveTo determine the diagnostic performance of nested real-time polymerase chain reaction (nRT-PCR) in HIV-infected TBM patients categorised according to standardised clinical case definitions.

designBased on clinical, laboratory and imaging data, HIV-infected patients with suspected TBM were prospectively categorised as 'definite TBM', 'probable TBM', 'possible TBM' or 'not TBM'. We evaluated nRT-PCR sensitivity and specificity in diagnosing TBM among definite TBM cases, and among definite + probable TBM cases.

resultsNinety-two participants were enrolled in the study. nRT-PCR sensitivity for definite TBM (n = 8) was 100% (95%CI 67-100) and 86% (95%CI 60-96) for both definite and probable TBM (n = 6). Assuming that 'not TBM' patients (n = 74) were true-negatives, nRT-PCR specificity was 100% (95%CI 95-100). The possible TBM group (n = 4) had no nRT-PCR positives.

conclusionsThe nRT-PCR is a useful rule-in test for HIV-infected patients with TBM according to international consensus case definitions. As nRT-PCR cannot exclude TBM, studies comparing and combining nRT-PCR with other assays are necessary for a rule-out test.

Indexed as

AdultFemaleHIV InfectionsHumansMaleMiddle AgedProspective StudiesReal-Time Polymerase Chain ReactionSensitivity and SpecificityTuberculosis, Meningeal

Identifiers

PMID28911358
PMCPMC12495549
OpenAlexW2756118939

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.