17 results on '"Bhavani, Perumal Kannabiran"'
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2. Effect of Metformin on Plasma Exposure of Rifampicin, Isoniazid, and Pyrazinamide in Patients on Treatment for Pulmonary Tuberculosis
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Kumar, Agibothu Kupparam Hemanth, Kadam, Abhijit, Karunaianantham, Ramesh, Tamizhselvan, Manoharan, Padmapriyadarsini, Chandrasekaran, Mohan, Anant, Jeyadeepa, B., Radhakrishnan, Ammayappan, Singh, Urvashi B., Bapat, Shraddha, Mane, Aarti, Kumar, Pradeep, Mamulwar, Megha, Bhavani, Perumal Kannabiran, Haribabu, Hemalatha, Rath, Nibedita, Guleria, Randeep, Khan, Abdul Mabood, and Menon, Jaykumar
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- 2023
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3. Inadequate Lopinavir Concentrations With Modified 8-Hourly Lopinavir/Ritonavir 4: 1 Dosing During Rifampicin-based Tuberculosis Treatment in Children Living With HIV
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Chabala, Chishala, Turkova, Anna, Kapasa, Monica, LeBeau, Kristen, Tembo, Chimuka H., Zimba, Kevin, Weisner, Lubbe, Zyambo, Khozya, Choo, Louise, Chungu, Chalilwe, Lungu, Joyce, Mulenga, Veronica, Crook, Angela, Gibb, Diana, McIlleron, Helen, Gibb, Diana M., Turkova, Anna, Crook, Angela M., Choo, Louise, Wills, Genevieve, Thomason, Margaret J., Teera, Jaqueline, Owen- Powell, Ellen, LeBeau, Kristen, Baptiste, David, McGowan, Charlotte, Spyer, Moira, Chabala, Chishala, Mulenga, Veronica, Lungu, Joyce, Kapasa, Monica, Zimba, Kevin, Zyambo, Khozya, Chungu, Chalilwe, Tembo, Chimuka, Kunda, Sharon, Shingalili, Ellen, Zulu, Semy, Chipoya, Terence, Mwanakalanga, Habulembe, Chambela, Elias, Hankombo, Jessy M., Kalumbi, Mox Malama, Chola, Daniel, Malama, Stephen, Wobudeya, Eric, Musoke, Philippa, Baldwin, Mboizi Robert, Nansamba, Winnie, Ssenyonga, Mark, Ssengooba, Willy, Businge, Gerald, Hesseling, Anneke C., Palmer, Megan, van der Zalm, Marieke M., Workman, Jessica, Demers, Anne-Marie, Schaaf, Simon, Gie, Robert, Walters, Elisabetta, Zimri, Warren, Hoddinott, Graeme, Deventer, Anneen van, Goussard, Pierre, Morrison, Julie, Mave, Vidya, (PI), Kinikar, Aarti Avinash, Raichur, Priyanka, Nijampurkar, Aparna, Khan, Sameer, Hissar, Syed, Joseph, Bency, Bhavani, Perumal Kannabiran, Prathiksha, G, Baskaran, Dhanaraj, Gomathi, NS, Mythily, V, Kumar, Hemanth, Chelvi, Silambu, Sekar, L, Hanna, Luke, Ramesh, K, Latha, Hema, Bharathi, S, Banu, Parveen, Xavier, Dino, Kumar, Manjith, Guru, K, Kumar, Sasi, Kesavan, A, Gunasundari, A, Mangalambal, G, Nagarajan, Valarmathi, Shankar, Shakeela, Selvi, R, Vaishnavi, S, Yadav, Krishna, Supriya, R, Giranab, Hema, Seetha, A, Mary, Stella, Gopika, S, Rohini, S, Revathy, M, Balaji, Sarath, Elilarasi, S, Ganesh, J, Aravind, MA, Mulambo, Sylvia, Mwanyungwi, Hope, Tapse, Dharati, Sane, Manasi, Abdullah, Amina, Nakalanzi, Sarah, Williams, Cynthia Mukisa, McIlleron, Helen, Aarnoutse, Rob, Revill, Paul, Love-Koh, James, Walker, Simon, Mugyenyi, Peter, Darbyshire, Janet, Clayden, Polly, Donald, Peter, Singh, Varinder, Grzemska*, Malgosia, Swaminathan, Soumya, Verkuijl, *Replaced by Sabine, Peto, Tim, Mwinga, Alwyn, Fielding, Katherine, Graham, Stephen M., Welch, Steven B., Seddon, James A., Whittaker, Elizabeth, Anderson, Suzanne, and Grandjean, Louis
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- 2023
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4. BCG vaccination induces enhanced humoral responses in elderly individuals
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Kumar, Nathella Pavan, Padmapriyadarsini, Chandrasekaran, Rajamanickam, Anuradha, Bhavani, Perumal Kannabiran, Nancy, Arul, Jeyadeepa, B., Renji, Rachel Mariam, and Babu, Subash
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- 2023
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5. Suboptimal Antituberculosis Drug Concentrations and Outcomes in Small and HIV‐Coinfected Children in India: Recommendations for Dose Modifications
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Guiastrennec, Benjamin, Ramachandran, Geetha, Karlsson, Mats O, Kumar, AK Hemanth, Bhavani, Perumal Kannabiran, Gangadevi, N Poorana, Swaminathan, Soumya, Gupta, Amita, Dooley, Kelly E, and Savic, Radojka M
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Pediatric ,Rare Diseases ,Infectious Diseases ,Orphan Drug ,Prevention ,HIV/AIDS ,Tuberculosis ,Evaluation of treatments and therapeutic interventions ,Development of treatments and therapeutic interventions ,5.1 Pharmaceuticals ,6.1 Pharmaceuticals ,Infection ,Good Health and Well Being ,Adolescent ,Age Factors ,Antitubercular Agents ,Body Weight ,Child ,Child ,Preschool ,Coinfection ,Dose-Response Relationship ,Drug ,Drug Administration Schedule ,Drug Dosage Calculations ,Drug Monitoring ,Drug Therapy ,Combination ,Female ,HIV Infections ,Humans ,India ,Infant ,Isoniazid ,Male ,Models ,Biological ,Pyrazinamide ,Rifampin ,Time Factors ,Treatment Outcome ,Pharmacology and Pharmaceutical Sciences ,Pharmacology & Pharmacy ,Pharmacology and pharmaceutical sciences - Abstract
This work aimed to evaluate the once-daily antituberculosis treatment as recommended by the new Indian pediatric guidelines. Isoniazid, rifampin, and pyrazinamide concentration-time profiles and treatment outcome were obtained from 161 Indian children with drug-sensitive tuberculosis undergoing thrice-weekly dosing as per previous Indian pediatric guidelines. The exposure-response relationships were established using a population pharmacokinetic-pharmacodynamic approach. Rifampin exposure was identified as the unique predictor of treatment outcome. Consequently, children with low body weight (4-7 kg) and/or HIV infection, who displayed the lowest rifampin exposure, were associated with the highest probability of unfavorable treatment (therapy failure, death) outcome (Punfavorable ). Model-based simulation of optimized (Punfavorable ≤ 5%) rifampin once-daily doses were suggested per treatment weight band and HIV coinfection status (33% and 190% dose increase, respectively, from the new Indian guidelines). The established dose-exposure-response relationship could be pivotal in the development of future pediatric tuberculosis treatment guidelines.
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- 2018
6. Prevalence of non‐communicable diseases among household contacts of people with tuberculosis: A systematic review and individual participant data meta‐analysis.
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Hamada, Yohhei, Quartagno, Matteo, Malik, Farihah, Ntshamane, Keolebogile, Tisler, Anna, Gaikwad, Sanjay, Acuna‐Villaorduna, Carlos, Bhavani, Perumal Kannabiran, Alisjahbana, Bachti, Ronacher, Katharina, Apriani, Lika, Becerra, Mercedes, Chu, Alexander L., Creswell, Jacob, Diaz, Gustavo, Ferro, Beatriz E., Galea, Jerome T., Grandjean, Louis, Grewal, Harleen M. S., and Gupta, Amita
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Objective: To investigate the prevalence of non‐communicable diseases among household contacts of people with tuberculosis. Methods: We conducted a systematic review and individual participant data meta‐analysis. We searched Medline, Embase and the Global Index Medicus from inception to 16 May 2023. We included studies that assessed for at least one non‐communicable disease among household contacts of people with clinical tuberculosis. We estimated the non‐communicable disease prevalence through mixed effects logistic regression for studies providing individual participant data, and compared it with estimates from aggregated data meta‐analyses. Furthermore, we compared age and sex‐standardised non‐communicable disease prevalence with national‐level estimates standardised for age and sex. Results: We identified 39 eligible studies, of which 14 provided individual participant data (29,194 contacts). Of the remaining 25 studies, 18 studies reported aggregated data suitable for aggregated data meta‐analysis. In individual participant data analysis, the pooled prevalence of diabetes in studies that undertook biochemical testing was 8.8% (95% confidence interval [CI], 5.1%–14.9%, four studies). Age‐and sex‐standardised prevalence was higher in two studies (10.4% vs. 6.9% and 11.5% vs. 8.4%) than the corresponding national estimates and similar in two studies. Prevalence of diabetes mellitus based on self‐report or medical records was 3.4% (95% CI 2.6%–4.6%, 14 studies). Prevalence did not significantly differ compared to estimates from aggregated data meta‐analysis. There were limited data for other non‐communicable diseases. Conclusion: The prevalence of diabetes mellitus among household contacts was high while that of known diabetes was substantially lower, suggesting the underdiagnosis. tuberculosis household contact investigation offers opportunities to deliver multifaceted interventions to identify tuberculosis infection and disease, screen for non‐communicable diseases and address shared risk factors. [ABSTRACT FROM AUTHOR]
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- 2024
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7. BCG vaccination induces enhanced frequencies of dendritic cells and altered plasma levels of type I and type III interferons in elderly individuals
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Kumar, Nathella Pavan, Padmapriyadarsini, Chandrasekaran, Rajamanickam, Anuradha, Bhavani, Perumal Kannabiran, Nancy, Arul, Jeyadeepa, Bharathi, Selvaraj, Nandhini, Ashokan, Dinesh, Renji, Rachel Mariam, Venkataramani, Vijayalakshmi, Tripathy, Srikanth, and Babu, Subash
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- 2021
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8. High-Dose Rifampicin Mediated Systemic Alterations of Cytokines, Chemokines, Growth Factors, Microbial Translocation Markers, and Acute-Phase Proteins in Pulmonary Tuberculosis
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Kathamuthu, Gokul Raj, primary, Bhavani, Perumal Kannabiran, additional, Singh, Manjula, additional, Saini, Jitendra Kumar, additional, Aggarwal, Ashutosh, additional, Ansari, Mohammed Soheb S., additional, Garg, Rajiv, additional, and Babu, Subash, additional
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- 2022
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9. BCG vaccination induces enhanced frequencies of memory T cells and altered plasma levels of common γc cytokines in elderly individuals
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Kumar, Nathella Pavan, primary, Padmapriyadarsini, Chandrasekaran, additional, Rajamanickam, Anuradha, additional, Bhavani, Perumal Kannabiran, additional, Nancy, Arul, additional, Jayadeepa, Bharathi, additional, Selvaraj, Nandhini, additional, Asokan, Dinesh, additional, Renji, Rachel Mariam, additional, Venkataramani, Vijayalakshmi, additional, Tripathy, Srikanth, additional, and Babu, Subash, additional
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- 2021
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10. Defective dendritic cell response to Toll-like receptor 7/8 agonists in perinatally HIV-infected children
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Selvaraj, Anbalagan, Pilakka-Kanthikeel, Sudheesh, Bhavani, Perumal Kannabiran, Hanna, Luke E., Pahwa, Savita, and Swaminathan, Soumya
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- 2013
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11. BCG vaccination induces enhanced frequencies of memory T and B cells and dendritic cell subsets in elderly individuals
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Kumar, Nathella Pavan, primary, Padmapriyadarsini, Chandrasekaran, additional, Rajamanickam, Anuradha, additional, Bhavani, Perumal Kannabiran, additional, Nancy, Arul, additional, Jayadeepa, Bharathi, additional, Selveraj, Nandhini, additional, Kumar, Dinesh, additional, Renji, Rachel Mariam, additional, Venkataramani, Vijayalakshmi, additional, Tripathy, Srikanth, additional, and Babu, Subash, additional
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- 2020
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12. Daily vs Intermittent Antituberculosis Therapy for Pulmonary Tuberculosis in Patients With HIV
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Sekar Lakshman, Ramesh Kumar Santhanakrishnan, Srikanth Tripathy, Chandra Suresh, Alangudi Natarajan Palaniappan, Sridhar Rathinam, Gunasundari Arasan, Tamizhselvan Manoharan, Bhavani Perumal Kannabiran, Hemanth Kumar Kupparam Agiboth, Sekar Sathiyavelu, Padmapriyadarsini Chandrasekaran, Prabhakaran Rathinam, Stella Susaimuthu, Ravichandran Narayanan, Vijay Krishnamoorthy, Lavanya Jayabal, Murugesan Selvachitiram, Soumya Swaminathan, Devarajulu Reddy, Mahilmaran Ayyamperumal, Bhanu Kesavamurthy, Lakshmi Murali, Narendran Gopalan, Raja Krishnaraja, Chandrasekar Chockalingam, Nalini Jayanthi, Pradeep A. Menon, Kumar Satagopan, Gomathi Sivaramakrishnan, Prabhakar Angamuthu, and Ranjani Ramachandran
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Patient Dropouts ,Randomization ,Tuberculosis ,Anti-HIV Agents ,030106 microbiology ,Antitubercular Agents ,HIV Infections ,Drug Administration Schedule ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Immune Reconstitution Inflammatory Syndrome ,Interquartile range ,law ,Internal medicine ,Tuberculosis, Multidrug-Resistant ,Isoniazid ,Internal Medicine ,medicine ,Humans ,Treatment Failure ,030212 general & internal medicine ,Adverse effect ,Tuberculosis, Pulmonary ,Original Investigation ,Proportional Hazards Models ,business.industry ,Middle Aged ,Viral Load ,medicine.disease ,CD4 Lymphocyte Count ,Directly Observed Therapy ,Regimen ,Treatment Outcome ,Streptomycin ,Sputum ,Female ,Rifampin ,medicine.symptom ,business ,Viral load ,Ethambutol - Abstract
Importance The benefit of daily over thrice-weekly antituberculosis therapy among HIV-positive patients with pulmonary tuberculosis (TB) who are receiving antiretroviral therapy remains unproven. Objective To compare the efficacy and safety of daily, part-daily, and intermittent antituberculosis therapy regimens in the treatment of HIV-associated pulmonary TB. Design, Setting, and Participants This open-label, randomized clinical trial was conducted by the National Institute for Research in Tuberculosis, south India. Adults infected with HIV with newly diagnosed, culture-positive, pulmonary TB were enrolled between September 14, 2009, and January 18, 2016. Interventions Patients were randomized to daily, part-daily, and intermittent antituberculosis therapy regimens, stratified by baseline CD4 lymphocyte count and sputum smear grade. Antiretroviral therapy was initiated as per national guidelines. Clinical and sputum microbiological examinations of patients were performed monthly until 18 months after randomization. Adverse events were recorded using standard criteria. Main Outcomes and Measures The primary outcome was favorable response, defined as treatment completion with all available sputum cultures negative forMycobacterium tuberculosisduring the last 2 months of treatment. Unfavorable responses included treatment failures, dropouts, deaths, and toxic effects among regimens. Results Of 331 patients (251 [76%] male; mean [SD] age, 39 [9] years; mean [SD] HIV viral load, 4.9 [1.2] log10copies/mL; and median [interquartile range] CD4 lymphocyte count, 138 [69-248] cells/μL), favorable responses were experienced by 91% (89 of 98), 80% (77 of 96), and 77% (75 of 98) in the daily, part-daily, and intermittent regimens, respectively. With the difference in outcome between daily and intermittent regimens crossing the O’Brien-Fleming group sequential boundaries and acquired rifampicin resistance emergence (n = 4) confined to the intermittent group, the data safety monitoring committee halted the study. A total of 18 patients died and 18 patients dropped out during the treatment period in the 3 regimens. Six, 4, and 6 patients in the daily, part-daily, and intermittent regimens, respectively, had TB recurrence. Conclusions and Relevance Among HIV-positive patients with pulmonary TB receiving antiretroviral therapy, a daily anti-TB regimen proved superior to a thrice-weekly regimen in terms of efficacy and emergence of rifampicin resistance. Trial Registration clinicaltrials.gov Identifier:NCT00933790
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- 2018
13. Dyslipidaemia Among Children Living with HIV after 48 Weeks of First-line Antiretroviral Therapy
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Srinivasan R, Anita Shet, Padmapriyadarsini C, Bhavani Perumal Kannabiran, Suresh Elumalai, Poorana Ganga Devi N, Sanjeeva G N, Devarajulu Reddy, Soumya Swaminathan, and Christine Wanke
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Fasting lipid profile ,Pediatrics ,medicine.medical_specialty ,business.industry ,First line ,Abnormal lipid profile ,Human immunodeficiency virus (HIV) ,Poster Abstract ,medicine.disease_cause ,Antiretroviral therapy ,Zidovudine ,Abstracts ,Infectious Diseases ,Oncology ,Viral Load result ,medicine ,LDL Cholesterol Lipoproteins ,business ,medicine.drug - Abstract
Background Antiretroviral therapy (ART) associated dyslipidaemia has been reported among children living with HIV (CLHIV) in both developed and developing countries. Not much data is available on changes in blood lipid profile among CLHIV on first-line ART in India. Aims: To study the changes in the Lipid profile among CLHIVs, 12 months after initiating a non-nucleoside reverse transcriptase inhibitor-based (NNRTI) ART Methods A prospective multicentric study enrolled HIV infected children, between 2-12 years of age, initiating NNRTI-based ART in south India. Clinical details, anthropometry and fasting blood for estimating serum total cholesterol (TC), triglyceride (TGL), high-density cholesterol (HDL-c), low-density cholesterol (LDL-c), plasma viral load and CD4 cell counts was collected. These measurements were repeated at 6th and 12th month after ART initiation. Proportion of children with abnormal lipid profile at baseline and 12 months after ART were compared using McNemar test. Generalized linear model was applied to predict factors associated with changes in serum lipid levels 12 months post-ART. Results Of the 393 HIV-infected children, 66 % received Zidovudine and 14 % Stavudine in their ART regimen. After 12 months of ART, TC, LDL-c and HDL-c increased from baseline by a mean of 31mg/dL, 13.7 mg/dL and 19mg/dl, respectively. TC/HDL-c ratio decreased from a mean of 5.1 to 3.5 (all changes, P 200 mg/dL for 3% and 13% of patients, LDL-c was >130 mg/dL for 5% and 8%, HDL-c was 150 mg/dL for 38% and 24%. Baseline HIV viral load >400 copies/mL (P, 0.01) was associated with increase in HDL-c and lower TG levels (P, 0.008). Baseline CD4 %
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- 2017
14. Factors influencing plasma nevirapine levels: a study in HIV-infected children on generic antiretroviral treatment in India
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Poorana Ganga Devi Navaneethapandian, Geetha Ramachandran, Bhavani Perumal Kannabiran, Ira Shah, Soumya Swaminathan, Rajasekaran Sikhamani, Ramesh Karunaianandham, Hemanth Kumar Agibothu Kupparam, Vasantha Mahalingam, and Lakshmi Soundararajan
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Microbiology (medical) ,Male ,medicine.medical_specialty ,Nevirapine ,Anti-HIV Agents ,Population ,India ,HIV Infections ,Plasma ,Acquired immunodeficiency syndrome (AIDS) ,Pharmacokinetics ,Internal medicine ,Antiretroviral Therapy, Highly Active ,Blood plasma ,medicine ,Humans ,Pharmacology (medical) ,Sida ,education ,Child ,Chromatography, High Pressure Liquid ,Original Research ,Pharmacology ,education.field_of_study ,Models, Statistical ,Polymorphism, Genetic ,biology ,Reverse-transcriptase inhibitor ,Age Factors ,Infant ,Oxidoreductases, N-Demethylating ,medicine.disease ,biology.organism_classification ,Confidence interval ,Cytochrome P-450 CYP2B6 ,Infectious Diseases ,Child, Preschool ,Immunology ,Female ,Aryl Hydrocarbon Hydroxylases ,medicine.drug - Abstract
BACKGROUND: Nevirapine is an important component of paediatric combination HIV therapy. Adequate drug exposure is necessary in order to achieve long-lasting viral suppression. OBJECTIVES: To study the influence of age drug dose and formulation type nutritional status and CYP2B6 516G>T polymorphism on blood concentrations of nevirapine in children treated with generic antiretroviral drugs. METHODS: A multicentre study was conducted at four sites in India. HIV-infected children receiving generic nevirapine-based fixed-dose combinations were recruited. Trough and 2 h nevirapine plasma concentrations were determined by HPLC. Characterization of the CYP2B6 gene polymorphism was performed using direct sequencing. Clinical and nutritional status was recorded. Groups were compared using the Mann-Whitney U-test and multivariable logistic regression analysis was performed to identify factors contributing to low drug levels. RESULTS: Ninety-four children of median age 78 months were studied; 60% were undernourished or stunted. Stunted children had a significantly lower 2 h nevirapine concentration compared with non-stunted children (P < 0.05); there were no significant differences in trough concentrations between different nutritional groups. Nevirapine levels were significantly higher in children with TT compared with GG and GT CYP2B6 genotypes (P < 0.01). Children
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- 2011
15. Evaluation of a Diagnostic Algorithm for Sputum Smear–Negative Pulmonary Tuberculosis in HIV-Infected Adults
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Padmapriyadarsini, Chandrasekaran, primary, Tripathy, Srikanth, additional, Sekar, Lakshmanan, additional, Bhavani, Perumal Kannabiran, additional, Gaikwad, Nitin, additional, Annadurai, Srinivasan, additional, Narendran, Gopalan, additional, Selvakumar, Nagamiah, additional, Risbud, Arun R., additional, Sheta, Dinesh, additional, Rajasekaran, Sikhamani, additional, Thomas, Aleyamma, additional, Wares, Fraser, additional, and Swaminathan, Soumya, additional
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- 2013
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16. Pulmonary Mycobacterium abscessus and response to treatment in an outpatient setting: Case series.
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Gopalaswamy R, Padmapriyadarsini C, Sekar K, Vijayaragavan V, Bhavani PK, Lokanathan LM, Anandakrishnan S, and Sivaramakrishnan G
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- Anti-Bacterial Agents therapeutic use, Humans, Nontuberculous Mycobacteria, Outpatients, Lung Diseases drug therapy, Mycobacterium Infections, Nontuberculous diagnosis, Mycobacterium Infections, Nontuberculous drug therapy, Mycobacterium abscessus
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Pulmonary disease due to Mycobacterium abscessus (Mab) has become an increasing cause of health concern, particularly among individuals infected with nontuberculous mycobacteria. Since Mab is intrinsically resistant to many antibiotics, it is very challenging to treat patients with symptomatic disease. In this case series, we report four patients with symptomatic pulmonary Mab who had prior history of antituberculosis treatment intake and declared cured at the end of treatment. The current episode was confirmed to be due to Mab infection by molecular and clinical diagnosis and received species specific-antibiotics therapy. All were periodically monitored for the sputum smear and culture conversions throughout the treatment period. The clinical course was variable though all received similar antibiotic regimen and showed varied treatment outcomes. The time of diagnosis and the treatment outcome indicate that a better understanding of host-pathogen interactions is essential for the successful treatment of pulmonary Mab infection., Competing Interests: None
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- 2021
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17. Evaluation of a diagnostic algorithm for sputum smear-negative pulmonary tuberculosis in HIV-infected adults.
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Padmapriyadarsini C, Tripathy S, Sekar L, Bhavani PK, Gaikwad N, Annadurai S, Narendran G, Selvakumar N, Risbud AR, Sheta D, Rajasekaran S, Thomas A, Wares F, and Swaminathan S
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- Adult, Algorithms, CD4 Lymphocyte Count, Female, Humans, Male, Radiography, Sensitivity and Specificity, Tuberculosis, Pulmonary complications, HIV Infections complications, Lung diagnostic imaging, Sputum microbiology, Tuberculosis, Pulmonary diagnosis, Tuberculosis, Pulmonary diagnostic imaging
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Background: The Revised National TB Control Program bases diagnosis of tuberculosis (TB) on sputum smear examination and response to a course of antibiotics, whereas World Health Organization recommends early chest radiography [chest x-ray (CXR)] for HIV-infected symptomatic patients. We evaluated the utility of initial CXR in the diagnostic algorithm for symptomatic HIV-infected patients with negative sputum smears., Methods: HIV-infected ambulatory patients with cough or fever of ≥2 weeks and 3 sputum smears negative for acid-fast bacilli were enrolled in Chennai and Pune, India, between 2007 and 2009. After a CXR and 2 sputum cultures, a course of broad-spectrum antibiotics was given and patients were reviewed after 14 days. Sensitivity, specificity, positive and negative predictive values of symptoms, CXR, and various combinations for diagnosing pulmonary tuberculosis (PTB) were determined, using sputum culture as gold standard., Results: Five hundred four patients (330 males; mean age: 35 years; median CD4: 175 cells per cubic millimeter) were enrolled. CXR had a sensitivity and specificity of 72% and 57%, respectively, with positive predictive value (PPV) of 21% and negative predictive value (NPV) of 93% to diagnose PTB. TB culture was positive in 49 of 235 patients (21%) with an abnormal initial CXR and 19 of 269 patients (7%) with a normal CXR (P < 0.001). Sensitivity and specificity of cough ≥2 weeks for predicting PTB was 97% and 6%, with PPV and NPV of 14% and 94%, respectively., Conclusions: Although moderately sensitive, basing a diagnosis of TB on initial CXR leads to overdiagnosis. An absence of weight loss had a high NPV, whereas none of the combinations had a good PPV. A rapid and accurate diagnostic test is required for HIV-infected chest symptomatic.
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- 2013
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