Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital
Background: Acid fast bacilli (AFB) staining on bone marrow samples has low sensitivity for diagnosing HIVassociated tuberculosis and Tuberculosis (TB) culture results may be delayed. The GeneXpert® MTB/RIF Ultra assay may provide a more sensitive diagnostic test on bone marrow biopsy samples. Metho...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Department of Clinical Laboratory Sciences
2024
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867614247042678784 |
|---|---|
| access_status_str | Open Access |
| author | Baloyi, Xikombiso |
| author2 | Moodley, Clinton |
| author_browse | Baloyi, Xikombiso Moodley, Clinton |
| author_facet | Moodley, Clinton Baloyi, Xikombiso |
| author_sort | Baloyi, Xikombiso |
| collection | Thesis |
| description | Background: Acid fast bacilli (AFB) staining on bone marrow samples has low sensitivity for diagnosing HIVassociated tuberculosis and Tuberculosis (TB) culture results may be delayed. The GeneXpert® MTB/RIF Ultra assay may provide a more sensitive diagnostic test on bone marrow biopsy samples. Methods: We conducted a two-stage study in a tertiary hospital in South Africa, initially assessing the retrospective yield of TB diagnoses on bone marrow biopsies in adult HIV-positive participants retrospectively from 01-01-2019 to 31-07-2020. Subsequently, determining the prospective yield and diagnostic performance of the GeneXpert® MTB/RIF Ultra assay on bone marrow aspirate and peripheral blood samples in adult HIV-positive participants undergoing bone marrow biopsy from 11- 08-2020 to 31-01-2021. Results: One hundred and twenty-two biopsies were analysed, of which 59/122 were performed for haematological malignancy staging. Granulomata with AFB were detected in six samples, and nine new lymphoma diagnoses were made. Bone marrow TB culture detected only one non-tuberculous mycobacterial infection. All 17 participants who had TB diagnosed from another clinical site were bone marrow TB culture negative. TB treatment was confirmed in 11/33 participants recruited prospectively. One trace positive GeneXpert® MTB/RIF Ultra result on peripheral blood was detected. All TB cultures on bone marrow aspirates and peripheral blood were negative. Conclusion: In a tertiary care hospital in South Africa, the utility of TB culture and GeneXpert® MTB/RIF Ultra on bone marrow aspirate specimens in HIV-positive participants was limited. We postulate that the initiation of empiric anti-tuberculosis treatment could have resulted in false negative results. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/39276 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:49:00.359Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Department of Clinical Laboratory Sciences |
| publisherStr | Department of Clinical Laboratory Sciences |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/39276 Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital Baloyi, Xikombiso Moodley, Clinton Verburgh Estelle Clinical Laboratory Sciences Background: Acid fast bacilli (AFB) staining on bone marrow samples has low sensitivity for diagnosing HIVassociated tuberculosis and Tuberculosis (TB) culture results may be delayed. The GeneXpert® MTB/RIF Ultra assay may provide a more sensitive diagnostic test on bone marrow biopsy samples. Methods: We conducted a two-stage study in a tertiary hospital in South Africa, initially assessing the retrospective yield of TB diagnoses on bone marrow biopsies in adult HIV-positive participants retrospectively from 01-01-2019 to 31-07-2020. Subsequently, determining the prospective yield and diagnostic performance of the GeneXpert® MTB/RIF Ultra assay on bone marrow aspirate and peripheral blood samples in adult HIV-positive participants undergoing bone marrow biopsy from 11- 08-2020 to 31-01-2021. Results: One hundred and twenty-two biopsies were analysed, of which 59/122 were performed for haematological malignancy staging. Granulomata with AFB were detected in six samples, and nine new lymphoma diagnoses were made. Bone marrow TB culture detected only one non-tuberculous mycobacterial infection. All 17 participants who had TB diagnosed from another clinical site were bone marrow TB culture negative. TB treatment was confirmed in 11/33 participants recruited prospectively. One trace positive GeneXpert® MTB/RIF Ultra result on peripheral blood was detected. All TB cultures on bone marrow aspirates and peripheral blood were negative. Conclusion: In a tertiary care hospital in South Africa, the utility of TB culture and GeneXpert® MTB/RIF Ultra on bone marrow aspirate specimens in HIV-positive participants was limited. We postulate that the initiation of empiric anti-tuberculosis treatment could have resulted in false negative results. 2024-04-03T12:48:27Z 2024-04-03T12:48:27Z 2023 2024-03-28T09:58:20Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/39276 eng application/pdf Department of Clinical Laboratory Sciences Faculty of Health Sciences |
| spellingShingle | Clinical Laboratory Sciences Baloyi, Xikombiso Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital |
| thesis_degree_str | Master's |
| title | Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital |
| title_full | Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital |
| title_fullStr | Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital |
| title_full_unstemmed | Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital |
| title_short | Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital |
| title_sort | diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in hiv positive patients at groote schuur hospital |
| topic | Clinical Laboratory Sciences |
| url | http://hdl.handle.net/11427/39276 |
| work_keys_str_mv | AT baloyixikombiso diagnosticyieldoftuberculosisinvestigationsonbonemarrowbiopsysamplesinhivpositivepatientsatgrooteschuurhospital |