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Tuberculosis case finding and mortality prediction: added value of the clinical TBscore and biomarker suPAR

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  5. Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients

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  1. Association Between Elevated suPAR, a New Biomarker of Inflammation, and Accelerated Aging

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  2. Validation of suPAR turbidimetric assay on Cobas® (c502 and c702) and comparison to suPAR ELISA

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  3. Elevated suPAR Is an Independent Risk Marker for Incident Kidney Disease in Acute Medical Patients

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SETTING: A suburban area of Bissau, the capital of Guinea-Bissau; the study was conducted among presumptive pulmonary tuberculosis (prePTB) patients seeking medical care for signs and symptoms suggestive of PTB.

OBJECTIVE: To determine if a clinical TB score and a biomarker suPAR (soluble urokinase plasminogen activator receptor) have separate and composite ability to predict PTB diagnosis and mortality in prePTB patients.

DESIGN: Observational prospective follow-up study conducted from August 2010 to August 2012.

RESULTS: We included 1011 prePTB patients (mean age 34 years, 95%CI 33-35); 55% (n = 559) were female and 161 (16%) had human immunodeficiency virus (HIV) infection. Of all included patients, 10% (n = 101) were diagnosed with PTB. Mortality during follow-up was 5% (n = 48), with a mean survival time of 158 days (95%CI 27-289) in prePTB patients diagnosed with PTB vs. 144 days (95%CI 109-178) in those not diagnosed with PTB (P = 0.774). After adjusting for HIV status and age, the best separate predictor was suPAR 5 ng/ml, with a hazard ratio (HR) of 4.6 (95%CI 2.1-9.9) for mortality and 6.7 (95%CI 4.0-11.2) for TB diagnosis. All patients who died had a TBscore II + suPAR 7; the HR of the composite score for subsequent PTB diagnosis was 33.0 (95%CI 4.6-236.6).

CONCLUSION: The proposed composite score of suPAR + TBscore II 7 can improve TB case finding and clinical monitoring.

Original languageEnglish
JournalThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
Volume21
Issue number1
Pages (from-to)67-72
ISSN1027-3719
DOIs
Publication statusPublished - 1 Jan 2017

ID: 49798164