Evidence map›Paper›PMID 33482745›Full record

ArticleBMC infectious diseases2021

Diagnostic accuracy of a liquid chromatography-tandem mass spectrometry assay in small hair samples for rifampin-resistant tuberculosis drug concentrations in a routine care setting.

John Metcalfe, Peter Bacchetti, Ali Esmail, Andrew Reckers, David Aguilar, Anita Wen, Shu Huo, Winnie R Muyindike, Judith A Hahn, Keertan Dheda and 2 more

Open access · goldAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 44% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Quantum Dot-Based Nanosensors for In Vitro Detection ofNanomaterials (Basel, Switzerland) · 2024
    Review
  4. 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

12 authors at 4 institutions in 3 countries.

John MetcalfeDivision of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, 1001 Potrero Avenue, Rm 5K1, San Francisco, CA, 94110-0111, USA. john.metcalfe@ucsf.edu.ORCID http://orcid.org/0000-0002-2279-7036
Peter BacchettiDepartment of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA.
Ali EsmailLung Infection and Immunity Unit, Division of Pulmonology, University of Cape Town, Cape Town, South Africa.
Andrew ReckersMaternal-Fetal Medicine Division, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
David AguilarMaternal-Fetal Medicine Division, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
Anita WenMaternal-Fetal Medicine Division, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
Shu HuoDivision of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, 1001 Potrero Avenue, Rm 5K1, San Francisco, CA, 94110-0111, USA.
Winnie R MuyindikeMbarara University of Science and Technology, Mbarara, Uganda.
Judith A HahnDivision of HIV, Infectious Diseases and Global Medicine, Department of Medicine, UCSF, San Francisco, CA, USA.
Keertan DhedaLung Infection and Immunity Unit, Division of Pulmonology, University of Cape Town, Cape Town, South Africa.
Monica GandhiDivision of HIV, Infectious Diseases and Global Medicine, Department of Medicine, UCSF, San Francisco, CA, USA.
Roy GeronaMaternal-Fetal Medicine Division, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
University of California, San Francisco · USSan Francisco General Hospital · USUniversity of Cape Town · ZAMbarara University of Science and Technology · UG

Funding

URBAN ARCH (3/5) Uganda Cohort TB preventive therapy for HIV-infected alcohol users in Uganda: an evaluation of safety tolerability and adherenceU01AA020776 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HAHN, JUDITH ALISSA · 2011 to 2021
$4.7M
Novel methods of pharmacologic monitoring for multidrug resistant tuberculosis treatment in the setting of HIV infectionR01AI123024 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GANDHI, MONICA, METCALFE, JOHN ZAPATA · 2016 to 2020
$3.6M
Training in Research Program on Alcohol Use by Persons with our at Risk for HIVK24AA022586 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HAHN, JUDITH ALISSA · 2013 to 2023
$1.8M
NIAAA NIH HHS K24 AA022586NIAAA NIH HHS U01020776NIAAA NIH HHS U01 AA020776NIAID NIH HHS R01 AI123024
6 · The paper itself

Abstract

backgroundTreatment monitoring of drug-resistant tuberculosis (DR-TB) in resource-limited settings is challenging. We developed a multi-analyte assay for eleven anti-TB drugs in small hair samples as an objective metric of drug exposure.

methodsSmall hair samples were collected from participants at various timepoints during directly observed RR-TB treatment at an inpatient tertiary referral facility in South Africa (DR-TB cohort). We assessed qualitative determination (i.e., detection above limit of detection) of bedaquiline, linezolid, clofazimine, pretomanid, levofloxacin, moxifloxacin, pyrazinamide, isoniazid, ethambutol, ethionamide, and prothionamide in an LC-MS/MS index panel assay against a reference standard of inpatient treatment records. Because treatment regimens prior to hospitalization were not available, we also analyzed specificity (for all drugs except isoniazid) using an external cohort of HIV-positive patients treated for latent TB infection with daily isoniazid (HIV/LTBI cohort) in Uganda.

resultsAmong the 57 DR-TB patients (58% with pre-XDR/XDR-TB; 70% HIV-positive) contributing analyzable hair samples, the sensitivity of the investigational assay was 94% or higher for all drugs except ethionamide (58.5, 95% confidence interval [CI], 40.7-99.9). Assay specificity was low across all tested analytes within the DR-TB cohort; conversely, assay specificity was 100% for all drugs in the HIV/LTBI cohort.

conclusionsHair drug concentrations reflect long-term exposure, and multiple successive regimens commonly employed in DR-TB treatment may result in apparent false-positive qualitative and falsely elevated quantitative hair drug levels when prior treatment histories within the hair growth window are not known.

Indexed as

AdultAntitubercular AgentsChromatography, LiquidDrug MonitoringFemaleHairHumansMaleMiddle AgedMycobacterium tuberculosisRifampinSensitivity and SpecificityTandem Mass SpectrometryTuberculosisTuberculosis, Multidrug-ResistantAntitubercular AgentsRifampinHairLC-MS/MSMultidrug-resistant tuberculosis

Identifiers

PMID33482745
PMCPMC7821664
OpenAlexW3121608459

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.