COMPARATIVE ACCURACY BETWEEN CARTRIDGE-BASED NUCLEIC ACID AMPLIFICATION TEST (CBNAAT) AND SPUTUM MICROSCOPY IN HUMAN IMMUNODEFICIENCY (HIV) PATENTS

Abstract

Background: Among individuals with HIV, the most prevalent opportunistic illness is Tuberculosis (TB). TB bacilli is detected by a CBNNAT [cartridge-based nucleic acid amplification test]. The most significant obstacle to the worldwide control of tuberculosis
bacteria is still the accuracy of tuberculosis diagnosis. For diagnosis of tuberculosis, Direct sputum smear microscopy is used. To diagnose tuberculosis, The Revised National Tuberculosis Control Program (RNTCP) uses the Cartridge-Based Nucleic Acid
Amplification Test (CBNAAT). The current study aims to compare the accuracy of diagnosis between CBNNAT and Sputum microscopy for pulmonary tuberculosis (TB).
Material & Methods: This prospective study was conducted between July 1, 2022, and May 31, 2023, among patients of HIV with suspicion of pulmonary TB who visited the General Medicine department at the National Institute of Medical Sciences and Research, NIMS University, Jaipur.
Results: 110 study subjects were taken. Out of them, 55.4% were male, and the most prevalent age range was middle age (31years-40 years), presented with fever (60%), weight loss (30%), 22% of patients presented with cough followed by 18% with breathlessness, 15%
with only fever, and 12% with cough. Sputum microscopy through ZN staining displayed 31.2% sensitivity and 89% specificity. CBNAAT showed high sensitivity (97.9%) and specificity (98%). Compared to sputum microscopy, it was substantially more accurate (0.95
vs. 0.72, mean diff 0.23 (0.096-0.37), p<0.001).Conclusions: According to the study's findings, TB diagnosis through culture is still the gold standard; however, CBNAAT has supplanted it as the diagnostic preferred approach because of its rapid turnaround time and excellent sensitivity.