Nur I Afriliyantina1, Anna Uyainah2, Evy Yunihastuti3, Anis Karuniawati4, Cleopas M Rumende2
1Departemen Ilmu Penyakit Dalam FKUI/RSCM
2Divisi Pulmonologi dan Perawatan Penyakit Kritis, Departemen Ilmu Penyakit Dalam FKUI/RSCM 3Divisi Alegi dan Imunologi, Departemen Ilmu Penyakit Dalam FKUI/RSCM
4Departemen Mikrobiologi FKUI/RSCM

ABSTRACT
Background: Tuberculosis is one of the most common presenting illness and the leading cause of death among people living with HIV. The clinical features of pulmonary tuberculosis in HIV-infected patients are not typical. The accurate diagnosis of pulmonary tuberculosis in HIV-infected patient remains a clinical challenge. Xpert MTB/RIF® is a new molecular modality for rapid diagnostic of tuberculosis. However, performance-related data from HIV-infected patients are still limited.
Objective: To determine the accuracy of Xpert MTB/RIF® in diagnosing pulmonary tuberculosis in HIV-infected patients from sputum sample.
Methods: This is a cross-sectional study performed in HIV-infected patients who were suspected of having pulmonary tuberculosis during October 2012 to April 2013 in Cipto Mangunkusumo Hospital. We investigated the diagnostic accuracy of Xpert MTB/RIF® compared to liquid media culture from sputum sample
Results: A total of 66 patients were suspected of having pulmonary tuberculosis and 43 patients were confirmed by culture examinations. Most of the patients were 25 - 35 years olds (58%), male (73%), have a low BMI (53%) and low CD4+ (56%). Most of HIV-infected patients were intravenous drugs user (62%). The sensitivity and specificity of Xpert MTB/RIF® were 93.0% (95% CI, 87.0% to 99.0%) and 91.3% (95% CI, 84.5% to 98.1%). The positive and negative predictive values were 95.2% (95% CI, 90.1% to 100%) and 87.5% (95% CI, 79.5% to 95.5%). Positive and negative likelihood ratios were 10.7 and 0.08.
Conclusion: Xpert MTB/RIF® has a good performance in diagnosing pulmonary tuberculosis in HIV-infected patients.
Key words: Tuberculosis, Xpert MTB/RIF®, HIV.,