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False positives in TB diagnosis lead to real negatives for HIV patients
Date:5/16/2010

ATS 2010, NEW ORLEANS HIV-infected patients who are falsely diagnosed as having tuberculosis (TB) have higher rates of mortality than those who are correctly diagnosed with the disease, according to a study conducted by researchers at University of California-San Francisco and Makerere University-Kampala.

"Among HIV-infected persons with suspected TB, falsely diagnosing persons with TB by rapid testing was associated with increased mortality when compared with the group of patients who received the correct diagnosis," said study lead author Robert Blount, M.D., clinical fellow in pulmonary and critical care medicine at UCSF's School of Medicine.

The results of the study will be presented at the ATS 2010 International Conference in New Orleans, with co-authors Laurence Huang, Lucian Davis, Adithya Cattamanchi, Saskia den Boon, William Worodria and Moses Joloba also in attendance

"Tuberculosis remains a common cause of pulmonary disease worldwide," Dr. Blount said. "HIV-infected patients are particularly susceptible to TB. Diagnosis can be a challenge, because the standard test-- sputum culturep although sensitive and specific, often takes several weeks to yield results."

Physicians and researchers have long understood that missing a positive diagnosis of tuberculosis in patients who actually have the disease can result in poor outcomes and an increase in mortality rates. But the link between mortality and false positives diagnosing someone with tuberculosis who does not have the disease has been less widely understood.

In this study, Dr. Blount and his colleagues evaluated the outcomes of 600 HIV-infected patients who were treated at Mulago Hospital in Kampala, Uganda, including patients who were incorrectly diagnosed with tuberculosis following rapid testing.

"Studies tend to emphasize the negative impact of missing the diagnosis of TB," Dr. Blount noted. "Our study shows that falsely diagnosing patients with
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Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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