Lateral flow urine lipoarabinomannan assay for extrapulmonary tuberculosis diagnosis in adults who are HIV-positive

Background: The diagnosis of extrapulmonary tuberculosis (EPTB) in patients with HIV remains a chal-lenge for clinicians. The World Health Organization recommends the detection of lipoarabinomannan (LAM) for diagnosing pulmonary tuberculosis in patients with HIV. A new generation of urine LAM tests (FujiLAM (R)) is available. However, studies regarding its accuracy are limited.Objective: This study aimed to evaluate the accuracy of urine LAM tests using FujiLAM (R) for diagnosing EPTB in patients with HIV.Methods: A cross-sectional study using urine samples of patients at Cipto Mangunkusumo Hospital, In-donesia, was performed from January 2020 to December 2020. Fresh urine was applied to the FujiLAM (R). Patients were grouped into definitive, probable, and non-TB groups. The diagnostic accuracy of the urine LAM test was compared with other Mycobacterium tuberculosis specimen gold standard tests.Results: Among 62 patients, 16 patients (25.8%) had definitive diagnosis of EPTB. Among those with definitive TB, an urine LAM test yielded a sensitivity of 75% (95% confidence interval [CI]: 47.62-92.73%) and specificity of 73.91% (95% CI: 87-85.73%). Meanwhile, compared with all diagnostic tests (defi-nite + probable TB), FujiLAM (R) had a sensitivity value of 61% (95% CI 43.36-76.86%) and a specificity value of 92.31% (95% CI 74.87-99.05%).Conclusion: The FujiLAM (R) test is a feasible method for diagnosing EPTB in patients with HIV. (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )