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Faster Identification of TB and Evaluation of Drug Resistance in HIV-infected People

Completed
Conditions
HIV Infections
Registration Number
NCT00959088
Lead Sponsor
Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections
Brief Summary

Early identification of tuberculosis (TB) is of particular importance in HIV-infected individuals, as a delay of therapy can be devastating in those with compromised immune systems. Diagnosis of TB in HIV is difficult, however, because 24-61% of HIV co-infected individuals with pulmonary TB have negative TB test results. In addition, conventional testing can take 6 weeks or longer and may not be available at all in many settings. This study is being conducted to see whether some new tests for identifying TB and for identifying resistance to TB drugs are at least as accurate as the current testing methods when used on HIV-infected individuals. The study will also assess whether the new tests can provide accurate results faster than the current methods.

Detailed Description

Early diagnosis of tuberculosis (TB) is of particular importance in HIV-infected individuals, as a delay of therapy can be devastating in those with compromised immune systems. Diagnosis of TB in HIV can be a particular challenge, however, because 24-61% of HIV co-infected individuals with pulmonary TB are smear-negative. Conventional solid media-based culture can take 6 weeks or longer for mycobacterial growth, and may not be available at all in many settings. The purpose of this study is to determine whether new tests for identifying TB and resistance to TB drugs are as effective as current tests and if these new tests can provide accurate results faster than the current method of testing for TB and drug resistance.

This trial will enroll HIV-infected individuals who are suspected to be co-infected with TB. Participants may be in this trial for up to nine months, depending on their test results. During the study, participants will provide one or two sputum samples, have a chest x-ray, and may have blood collected.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
641
Inclusion Criteria
  • HIV-1 infection, as documented at any time prior to study entry by a rapid HIV test or any licensed ELISA test kit
  • Probable or confirmed pulmonary TB at the time of enrollment
  • Current use of an anti-TB regimen for treatment of active TB for fewer than 7 days prior to sputum sample collection or anticipated initiation of same within 30 days after study entry
  • Ability and willingness of participant or legal guardian/representative to provide informed consent.

Exclusion Criteria

  • Receipt of 7 or more cumulative days of anti-TB treatment within 12 months prior to sputum collection
  • Inability to provide sputum sample
Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
GenoType Direct line probe assay result (MTB-positive or negative) and conventional mycobacterial culture assay result (MTB-positive or negative) on direct sputum samplesThroughout study
Secondary Outcome Measures
NameTimeMethod
MTB culture results (including speciation and, if indicated, drug susceptibility)Throughout study
Follow up clinical assessment of MTB disease statusThroughout study
GenoType Direct line probe assay results on direct sputum samplesThroughout study
GenoType MTBDR Plus line probe assay results on cultured and direct sputum samplesThroughout study
MTB blood culture resultsThroughout study
Identified strains of drug resistant MTBThroughout study
AFB smear with ZN staining resultsThroughout study
AFB smear as evaluated with fluorescent microscopy resultsThroughout study

Trial Locations

Locations (3)

Instituto de Pesquisa Clinica Evandro Chagas (12101)

🇧🇷

Rio de Janeiro, Brazil

Asociacion Civil Impacta Salud y Educacion - Miraf CRS (11301)

🇵🇪

Lima, Peru

Wits HIV CRS

🇿🇦

Johannesburg, Gauteng, South Africa

Instituto de Pesquisa Clinica Evandro Chagas (12101)
🇧🇷Rio de Janeiro, Brazil

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