Tuberculous is the leading cause of death for people with HIV, accountingfor about 360,000 deaths in 2013.
Fatalities are significantly higher in individuals with tuberculosis plus HIV co-infection because of increased disseminated extra-pulmonary tuberculosis, and more severe forms of disease associated with progressive immunosuppression.
Tuberculosis is the cause of death in nearly 40% of HIV-positive patients most having disseminated disease (85%) and nearly half remaining undiagnosed at the time of death.
Tuberculosis and HIV co-infection patients are often unable to expectorate, or have extra-pulmonary disease, needing sputum induction or alternative invasive sampling to acquire material for diagnosing tuberculosis.
Patients with tuberculosis and HIV co-infection with advanced immunosuppression often have low bacillary loads and other body fluids thus reducing the sensitivity of traditional diagnostic tests and nucleic acid amplification based diagnostics.
The Alere Determine tuberculous lipoarabinomannan Ag lateral flow strip test is a commercially available bedside tuberculosis diagnostic test providing a result within 25 minutes, using 60 mL of urine to detect lipoarabinomannan, a glycolipid antigen of the M tuberculosis cell wall.