Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital

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dc.contributor.advisorMoodley, Clinton
dc.contributor.advisorVerburgh Estelle
dc.contributor.authorBaloyi, Xikombiso
dc.date.accessioned2024-04-03T12:48:27Z
dc.date.available2024-04-03T12:48:27Z
dc.date.issued2023
dc.date.updated2024-03-28T09:58:20Z
dc.description.abstractBackground: 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.
dc.identifier.apacitationBaloyi, X. (2023). <i>Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital</i>. (). ,Faculty of Health Sciences ,Department of Clinical Laboratory Sciences. Retrieved from http://hdl.handle.net/11427/39276en_ZA
dc.identifier.chicagocitationBaloyi, Xikombiso. <i>"Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital."</i> ., ,Faculty of Health Sciences ,Department of Clinical Laboratory Sciences, 2023. http://hdl.handle.net/11427/39276en_ZA
dc.identifier.citationBaloyi, X. 2023. Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital. . ,Faculty of Health Sciences ,Department of Clinical Laboratory Sciences. http://hdl.handle.net/11427/39276en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Baloyi, Xikombiso AB - 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. DA - 2023 DB - OpenUCT DP - University of Cape Town KW - Clinical Laboratory Sciences LK - https://open.uct.ac.za PY - 2023 T1 - Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital TI - Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital UR - http://hdl.handle.net/11427/39276 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/39276
dc.identifier.vancouvercitationBaloyi X. Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital. []. ,Faculty of Health Sciences ,Department of Clinical Laboratory Sciences, 2023 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/39276en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Clinical Laboratory Sciences
dc.publisher.facultyFaculty of Health Sciences
dc.subjectClinical Laboratory Sciences
dc.titleDiagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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