ArticleAIDS (London, England)2018
C-reactive protein as a screening test for HIV-associated pulmonary tuberculosis prior to antiretroviral therapy in South Africa.
Article in AIDS (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04557176 (TB Screening Improves Preventive Therapy Uptake Trial), which is not on this map. Cited by 33 papers, 5 of them syntheses that pooled it.
What it found
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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.
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.
TB Screening Improves Preventive Therapy Uptake Trial
Who cites it
33 citing papers in PubMed, 5 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Host blood protein biomarkers to screen for tuberculosis disease: a systematic review and meta-analysis.Journal of clinical microbiology · 2024Pooled it
- Clinical utility of WHO-recommended screening tools and development and validation of novel clinical prediction models for pulmonary tuberculosis screening among outpatients living with HIV: an individual participant data meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Tuberculosis screening among ambulatory people living with HIV: a systematic review and individual participant data meta-analysis.The Lancet. Infectious diseases · 2022Pooled it
- Screening performance of C-reactive protein for active pulmonary tuberculosis in HIV-positive patients: A systematic review with a meta-analysis.Frontiers in immunology · 2022Pooled it
- A systematic review of the number needed to screen for active TB among people living with HIV.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2021Pooled it
- Evaluation of C-Reactive Protein and Computer-Aided Analysis of Chest X-rays as Tuberculosis Triage Tests at Health Facilities in Lesotho and South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- Current and Emerging Diagnostic Approaches for Tuberculosis in People Living with HIV: Challenges and Future Perspectives.Tropical medicine and infectious disease · 2026Review
- Predictive Value of C-reactive Protein for Hospitalization and Mortality Among People With Advanced HIV Disease in Uganda Receiving the World Health Organization-recommended Package of Care.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Screening and diagnostic strategies for active pulmonary tuberculosis among people in prison in Malaysia: a prospective diagnostic study.The Lancet regional health. Western Pacific · 2025Article
- Diagnostic accuracy of point-of-care triage tests for pulmonary tuberculosis using host blood protein biomarkers: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- C-Reactive Protein for Tuberculosis Triage Testing Is Not the Answer for Some Populations-Did We Ask the Right Question?American journal of respiratory and critical care medicine · 2025Article
- Effectiveness of C-Reactive Protein as a Tuberculosis Screening Test Among HIV-Infected Individuals - Shanghai, China, 2021-2023.China CDC weekly · 2024Article
- Potential Utility of C-reactive Protein for Tuberculosis Risk Stratification Among Patients With Non-Meningitic Symptoms at HIV Diagnosis in Low- and Middle-income Countries.Open forum infectious diseases · 2024Article
- Point-of-care C-reactive protein and Xpert MTB/RIF Ultra for tuberculosis screening and diagnosis in unselected antiretroviral therapy initiators: a prospective, cross-sectional, diagnostic accuracy study.The Lancet. Global health · 2024Article
- Predictors contributing to the estimation of pulmonary tuberculosis among adults in a resource-limited setting: A systematic review of diagnostic predictions.SAGE open medicine · 2024Review
- Article
- Landscape of TB Infection and Prevention among People Living with HIV.Pathogens (Basel, Switzerland) · 2022Review
- Implications of covariate induced test dependence on the diagnostic accuracy of latent class analysis in pulmonary tuberculosis.Journal of clinical tuberculosis and other mycobacterial diseases · 2022Article
- The Role of C-Reactive Protein as a Triage Tool for Pulmonary Tuberculosis in Children.Journal of the Pediatric Infectious Diseases Society · 2022Article
- Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThere is an urgent need for more accurate screening tests for tuberculosis(TB). We assessed the diagnostic accuracy of C-reactive protein (CRP) as a screening test for active TB in HIV-infected ambulatory adults.
methodsCRP levels were measured in blood collected at the time of HIV testing.Diagnostic accuracy of CRP for pulmonary TB was calculated (reference standard: TB culture), compared to the WHO 4-symptom screen, consisting of cough, fever, night sweats, and weight loss. Diagnostic accuracy was also calculated for CRP in a larger cohort of HIV-infected adults with a positive symptom screen (reference standard: clinical or microbiological TB).
resultsAmong 425 HIV-infected outpatients systematically tested for pulmonary TB, TB culture was positive in 42 (10%), 279 (66%) had at least one TB-related symptom and 197 (46%) had a CRP more than 5 mg/l. The sensitivity of CRP and the TB symptom screen to detect TB was the same [90.5%; 95% confidence interval 77.4-97.3] but specificity of CRP was higher than for the TB symptom screen (58.5% vs. 37.1%, P < 0.001). Of persons with no symptoms and normal CRP, 99 (98%) had no TB. In another cohort of 749 patients presenting with at least one TB-related symptom and clinically evaluated, CRP had a sensitivity of 98.7% and specificity of 48.3%.
conclusionIn HIV-infected outpatients, CRP was as sensitive but substantially more specific than TB symptom screening. Use of CRP as a screening tool to exclude active TB could identify the same number of HIV-associated TB cases, but reduce the use of diagnostic sputum testing in TB-endemic regions.
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What OpenQuestion holds
Registered trials
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.