Clinical Impact of the Line Probe Assay and Xpert® MTB/RIF Assay in the Presumptive Diagnosis of Drug-Resistant Tuberculosis in Brazil: A Pragmatic Clinical Trial
Rev. Soc. Bras. Med. Trop
;
55: e0191, 2022. tab, graf
Article
in English
|
LILACS-Express
| LILACS
| ID: biblio-1360813
ABSTRACT
ABSTRACT Background:
Rapid molecular methods such as the line probe assay (LPA) and Xpert® MTB/RIF assay (Xpert) have been recommended by the World Health Organization for drug-resistant tuberculosis (DR-TB) diagnosis. We conducted an interventional trial in DR-TB reference centers in Brazil to evaluate the impact of the use of LPA and Xpert.Methods:
Patients with DR-TB were eligible if their drug susceptibility testing results were available to the treating physician at the time of consultation. The standard reference MGITTM 960 was compared with Xpert (arm 1) and LPA (arm 2). Effectiveness was considered as the start of the appropriate TB regimen that matched drug susceptibility testing (DST) and the proportions of culture conversion and favorable treatment outcomes after 6 months.Results:
A higher rate of empirical treatment was observed with MGIT alone than with the Xpert assay (97.0% vs. 45.0%) and LPA (98.2% vs. 67.5%). Patients started appropriate TB treatment more quickly than those in the MGIT group (median 15.0 vs. 40.5 days; p<0.01) in arm 1. Compared to the MGIT group, culture conversion after 6 months was higher for Xpert in arm 1 (90.9% vs. 79.3%, p=0.39) and LPA in arm 2 (80.0% vs. 83.0%, p=0.81).Conclusions:
In the Xpert arm, there was a significant reduction in days to the start of appropriate anti-TB treatment and a trend towards greater culture conversion in the sixth month.
Full text:
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Index:
LILACS (Americas)
Type of study:
Diagnostic study
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Rev. Soc. Bras. Med. Trop
Journal subject:
Tropical Medicine
Year:
2022
Type:
Article
/
Project document
Affiliation country:
Brazil
/
United States
/
United kingdom
Institution/Affiliation country:
Fundação Oswaldo Cruz/BR
/
Institute of Clinical Trials and Methodology/GB
/
Liverpool School of Tropical Medicine/GB
/
Secretaria da Saúde do Ceará/BR
/
Secretaria de Estado da Saúde de São Paulo/BR
/
Secretaria de Estado de Saúde do Rio Grande do Sul/BR
/
Secretaria de Estado de Saúde do Rio de Janeiro/BR
/
United Nations Childrens Fund/US
/
Universidade Federal de Ouro Preto/BR
/
Universidade Federal do Rio de Janeiro/BR
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