Evaluación del desempeño de pruebas diagnósticas de tuberculosis en pacientes VIH positivo en dos hospitales públicos de Bogotá
| Contribuinte(s) |
Rodriguez-Leguizamon, Giovanni |
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| Data(s) |
11/05/2016
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| Resumo |
La tuberculosis TB es una de las principales causas de muerte en el mundo en individuos con infección por VIH. En Colombia esta coinfección soporta una carga importante en la población general convirtiéndose en un problema de salud pública. En estos pacientes las pruebas diagnósticas tienen sensibilidad inferior y la enfermedad evoluciona con mayor frecuencia hacia formas diseminadas y rápidamente progresivas y su diagnóstico oportuno representa un reto en Salud. El objetivo de este proyecto es evaluar el desempeño de las pruebas diagnósticas convencionales y moleculares, para la detección de TB latente y activa pacientes con VIH, en dos hospitales públicos de Bogotá. Para TB latente se evaluó la concordancia entre las pruebas QuantiFERON-TB (QTF) y Tuberculina (PPD), sugiriendo superioridad del QTF sobre la PPD. Se evaluaron tres pruebas diagnósticas por su sensibilidad y especificidad, baciloscopia (BK), GenoType®MTBDR plus (Genotype) y PCR IS6110 teniendo como estándar de oro el cultivo. Los resultados de sensibilidad (S) y especificidad (E) de cada prueba con una prevalencia del 19,4 % de TB pulmonar y extrapulmonar en los pacientes que participaron del estudio fue: BK S: 64% E: 99,1%; Genotype S: 77,8% E: 94,5%; PCRIS6110 S: 73% E: 95,5%, de la misma forma se determinaron los valores predictivos positivos y negativos (VPP y VPN) BK: 88,9% y 94,8%, Genotype S: 77,8% E: 94,5%; PCRIS6110 S: 90% y 95,7%. Se concluyó bajo análisis de curva ROC que las pruebas muestran un rendimiento diagnóstico similar por separado en el diagnóstico de TB en pacientes con VIH, aumentando su rendimiento diagnostico cuando se combinan Universidad del Rosario Tuberculosis (TB) is one of the principal causes of deaths in the world, because of the infection of HIV. In Colombia this coinfection support an important charge in the general population, converting itself in a healthy problem. In these patients, the diagnostic trials have lower sensibility, and the illness evolves with a higher frequency to scattered toward forms and rapidly progressive and timely diagnosis is a challenge in health. The objective of this project is to evaluate the performance of conventional and molecular diagnostic tests for the detection of latent and active TB patients with HIV, in two public hospitals of Bogotá. For latent TB concordance between tests QuantiFERON-TB (QFT) and tuberculin (PPD) was evaluated, suggesting superiority of QFT on PPD. three diagnostic tests for their sensitivity and specificity, smear (BK), GenoType®MTBDR plus (Genotype) and PCR IS6110 having as oro standard cultivation were evaluated. The results of sensitivity (S) and specificity (E) of each test with a prevalence of 19.4% and extrapulmonary pulmonary TB patients enrolled in the study was: BK S: 64% E: 99.1%; Genotype S: 77.8% E: 94.5%; PCRIS6110 S: 73% E: 95.5%, in the same way the positive and negative predictive values (PPV and NPV) were determined BK: 88.9% and 94.8%, Genotype S: 77.8% E: 94.5%; PCRIS6110 S: 90% and 95.7%. It was concluded under ROC curve analysis tests show a similar diagnostic performance separately in the diagnosis of TB in HIV patients, increasing their diagnostic accuaricy when combined. |
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application/pdf |
| Identificador | |
| Idioma(s) |
spa |
| Publicador |
Facultad de medicina |
| Direitos |
info:eu-repo/semantics/openAccess |
| Fonte |
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Documento de consenso sobre diagnóstico, tratamiento y prevención de la tuberculosis. Archivos de Bronconeumología, 46(5), 255-274. |
| Palavras-Chave | #Epidemiología #614.4 #Epidemiología #Tuberculosis #Infecciones por VIH #Tuberculosis #Mycobacterium tuberculosis #latent tuberculosis #HIV #AIDS #TARGA #Diagnosis |
| Tipo |
info:eu-repo/semantics/bachelorThesis info:eu-repo/semantics/acceptedVersion |
