European Journal of Molecular & Clinical Medicine

A rapid, accurate, and reliable diagnostic test is needed for these patients so that early anti-tubercular treatment (ATT) can be started for preventing the transmission of TB and the clinical severity of the disease. Moreover, unnecessary treatment can be avoided in patients who do not have TB with the avoidance of additional expenditure on medication. Patients who are clinically suspected to have pulmonary tuberculosis, including those who have symptoms of cough with or without expectoration for >2 weeks, weight loss, fatigue, hemoptysis, and loss of appetite with sputum smear-negative for PTB were included for the study. Among the 80 cases studied, the total number of PTB cases diagnosed was 58 (72%). The total number of PTB cases being CBNAAT +ve was 52. The total number of PTB cases having positive LJ culture was 58 cases. The total number of cases, of other diseases diagnosed, was 22, which included 2 cases of malignancy (1-squamous cell carcinoma, 1- adenocarcinoma), 4 cases of fungal (mucormycosis and aspergilloma) pneumonia, and 16 cases of bacterial (Klebsiella, pseudomonas, CONS) pneumonia. The sensitivity of CBNAAT was 87.93%, specificity was 95.45%, positive predictive value 98.07%, Negative predictive value-75%.

Tuberculosis has huge impact in humanity with high mortality rate in developing countries. For diagnosis of tuberculosis sputum smear microscopy has been the primary method in low middle income countries. But sputum microscopy has its some limitation in its performance. But if bacterial load is less then100000/ML of sputum sample the sensitivity is grossly compromised. In 1930 Fluorescent microscopy was introduced for detection of TB, which shows better result in compared to ordinary microscopy/ ZN microscopy. Specificity, sensitivity, cost effectiveness, and cost benefit of fluorescent microscopy have not yet established. International guidance on quality assurance for fluorescent microscopy does not currently exist. Current methods of drug susceptibility testing of Mycobacterium tuberculosis are costly or time consumable task. As the multidrug resistance tuberculosis is increases so the fast, reliable and inexpensive methods are in need of for detection of Tuberculosis. In compared to microscopy sputum culture can detect far lower number of AFB. Moreover, culture make it possible to identify the mycobacterial species as well as perform drug susceptibility testing. Rapid and molecular technique are also established for diagnosis of TB

The main reason for this high mortality is the lack of proper diagnosis at the right time. This
is particularly important in patients with HIV and TB co-infection; especially with extra
pulmonary TB as the detection rates are low. There is an urgent need to implement newer
diagnostic modalities for the detection of TB especially in highly HIV prevalent areas.
Patients satisfying inclusion criteria i.e. HIV positive patients clinically and/or radiologically
suspected of pulmonary tuberculosis whose sputum AFB is reported negative were subjected
for CBNAAT. This was done with the intention of identifying yield of CBNAAT over
microscopy. Among patients with abnormal chest x-ray, 84.6% had positive CBNAAT while
in those with normal chest X-ray, 81.1% had negative CBNAAT. Hence majority of patients
with abnormal chest X-ray findings had positive CBNAAT while majority of those with
normal chest x-ray had negative CBNAAT.

Globally, an estimated 10.0 million (range, 9.0-11.1 million) people fell ill with TB in 2018, a
number that has been relatively stable in recent years. The burden of disease varies
enormously among countries, from fewer than five to more than 500 new cases per 100 000
population per year, with the global average being around 130. The sputum samples were
treated with a sample reagent (SR) containing sodium hydroxide and isopropanol. The SR
was added to the sample in a ratio of 2:1 and incubated at room temperature for 15 min. The
treated sample is then manually transferred to the cartridge which is loaded into the
GeneXpert instrument. A printable test result was obtained after 1hour 45 minutes.
Considering the chief complaints at presentation, majority of patients (96%) had cough,
followed by fever in 40% cases, shortness of breath in 22%, hemoptysis in 6% and weight
loss in 6%.

INTRODUCTION: Tuberculosis in the PLHIV population is a major cause of morbidity and mortality and presents a substantial hazard of nosocomial disease transmission to other patients and health care workers. These risks are heightened when patients have multidrug-resistant TB. To address these challenges, there is a critical need in such a setting for rapid, ef ective screening for TB and the detection of drug resistance and early initiation of treatment. Delayed treatment is associated with higher morbidity and mortality. METHOD: This was a cross-sectional survey among HIV infected adult patients attending A.R.T Nodal centers, Medicine Opd and ward and chest, and T.B OPD and wards. All the patients with presumptive pulmonary TB were assessed for sputum for microscopy AFB and underwent Drug susceptibility test (CBAAT) for Rifampicin resistance. The primary aim of the Study is “TO EVALUATE PATTERN OF RIFAMPICIN RESISTANCE IN SEROPOSITIVE HIV PATIENTS IN TERTIARY CARE CENTER IN WESTERN UTTAR PRADESH” RESULT: The present study concluded that the prevalence of sputum positive pulmonary tuberculosis is very high of 39% among presumptive pulmonary tuberculosis patients. BY using CBNAAT we found that 27% of rifampicin resistance was prevalent among 78 patients. In the study population maximum sputum, positive pulmonary tuberculosis was in-between age group 31 to 50 years. Majority 81% of the patients were male. CONCLUSION: Sputum microscopy has very low sensitivity (35.9%) in our study for diagnosing tuberculosis in PLHIV. whereas CBNAAT has a sensitivity of 95 %,it detected double numbers of patients than AFB microscopy