Abstract Recent evaluations of the GeneXpert MTB/RIF assay for the simultaneous detection of Mycobacterium tuberculosis and drug resistance in less than 2 h have stimulated tremendous enthusiasm. This is the breakthrough that tuberculosis (TB) control has been waiting for. In this (retrospective review) case study, sputum samples from strongly suspected pulmonary tuberculosis patients were collected and assessed for the GeneXpert MTB/RIF assay for diagnosing TB and drug resistance in comparison with other tests, including Ziehl–Neelsen smear and Löwenstein–Jensen test. Of 3,784 cases, 5.7% (216/3,784) were human immunodeficiency virus (HIV)-positive and TB co-infected patients. In diagnosing HIV-positive and TB co-infected cases, the sensitivity and specificity of GeneXpert were 76.4% and 100%. While in HIV-negative and TB suspected cases, the sensitivity and specificity were 95.6% and 100%. This new test represents a major milestone for global TB diagnosis and care. It also represents new hope for the millions of people who are at the highest risk of TB and drug-resistant disease. GeneXpert is World Health Organization-endorsed technology representing the gold standard for TB testing despite attaining less sensitivity for HIV and TB co-infected patients as compared to HIV-negative patients.

中文翻译：

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用于诊断 HIV 相关结核病的 GeneXpert 技术：扩大规模值得吗？

摘要 最近对 GeneXpert MTB/RIF 测定在不到 2 小时内同时检测结核分枝杆菌和耐药性的评估激发了极大的热情。这是结核病 (TB) 控制一直在等待的突破。在这个（回顾性审查）案例研究中，收集了强烈怀疑肺结核患者的痰液样本，并与其他测试（包括 Ziehl-Neelsen 涂片和 Löwenstein-Jensen 测试）进行比较，评估用于诊断结核病和耐药性的 GeneXpert MTB/RIF 检测. 在 3,784 例病例中，5.7% (216/3,784) 是人类免疫缺陷病毒 (HIV) 阳性和结核病合并感染患者。在诊断 HIV 阳性和 TB 合并感染病例时，GeneXpert 的敏感性和特异性分别为 76.4% 和 100%。在 HIV 阴性和结核病疑似病例中，敏感性和特异性分别为95.6%和100%。这项新测试代表了全球结核病诊断和护理的一个重要里程碑。它还代表着数百万处于结核病和耐药性疾病最高风险中的人的新希望。GeneXpert 是世界卫生组织认可的技术，代表了结核病检测的黄金标准，尽管与 HIV 阴性患者相比，它对 HIV 和结核病合并感染患者的敏感性较低。