Diagnostic accuracy of C-reactive protein for active pulmonary tuberculosis: a meta-analysis.

Journal Article (Journal Article;Review;Systematic Review)

SETTING: Systematic screening for active pulmonary tuberculosis (PTB) is recommended for high-risk populations, including people living with the human immunodeficiency virus (PLHIV); however, currently recommended TB screening tools are inadequate for most high-burden settings. OBJECTIVE: To determine whether C-reactive protein (CRP) possesses the necessary test characteristics to screen individuals for active PTB. DESIGN: We performed a systematic review and meta-analysis of studies evaluating the diagnostic accuracy of CRP (10 mg/l cut-off point) for culture-positive PTB. Pooled diagnostic accuracy estimates were generated using random-effects meta-analysis for out-patients and in-patients, and for pre-specified subgroups based on HIV status and test indication. RESULTS: We identified nine unique studies enrolling 1793 adults from out-patient (five studies, 1121 patients) and in-patient settings (five studies, 672 patients), 72% of whom had confirmed HIV infection. Among out-patients, CRP had high sensitivity (93%, 95%CI 88-98) and moderate specificity (60%, 95%CI 40-75) for active PTB. Specificity was lowest among in-patients (21%, 95%CI 6-52) and highest among out-patients undergoing TB screening (range 58-81%). There was no difference in summary estimates by HIV status. CONCLUSION: CRP, which is available as a simple, inexpensive and point-of-care test, can be used to screen PLHIV presenting for routine HIV/AIDS (acquired immune-deficiency syndrome) care for active TB.

Full Text

Duke Authors

Cited Authors

  • Yoon, C; Chaisson, LH; Patel, SM; Allen, IE; Drain, PK; Wilson, D; Cattamanchi, A

Published Date

  • September 1, 2017

Published In

Volume / Issue

  • 21 / 9

Start / End Page

  • 1013 - 1019

PubMed ID

  • 28826451

Pubmed Central ID

  • PMC5633000

Electronic International Standard Serial Number (EISSN)

  • 1815-7920

Digital Object Identifier (DOI)

  • 10.5588/ijtld.17.0078


  • eng

Conference Location

  • France