{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/39276"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/39276","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital","abstract":"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.","abstract_html":"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.","abstract_has_math":false,"creators":["Baloyi, Xikombiso"],"institution":"Department of Clinical Laboratory Sciences","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Moodley, Clinton","Verburgh Estelle"],"committee_chairs":[],"committee_members":[],"year":2023,"date_issued":"2023","date_published":"2023","updated_at":"2026-07-22T22:23:44Z","subjects":["Clinical Laboratory Sciences"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/39276","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Moodley, Clinton","Verburgh Estelle"]},{"key":"dc:creator","label":"Author","values":["Baloyi, Xikombiso"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2024-04-03T12:48:27Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2024-04-03T12:48:27Z"]},{"key":"dc:date.issued","label":"Date","values":["2023"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Clinical Laboratory Sciences"]},{"key":"dc:type","label":"Dc Type","values":["Thesis / Dissertation"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Clinical Laboratory Sciences"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/39276"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["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."]},{"key":"dc:title","label":"Title","values":["Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital"]}]}],"canonical_facts":{"dc:contributor.advisor":["Moodley, Clinton","Verburgh Estelle"],"dc:creator":["Baloyi, Xikombiso"],"dc:date.accessioned":["2024-04-03T12:48:27Z"],"dc:date.available":["2024-04-03T12:48:27Z"],"dc:date.issued":["2023"],"dc:description.abstract":["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."],"dc:identifier.uri":["http://hdl.handle.net/11427/39276"],"dc:publisher.department":["Department of Clinical Laboratory Sciences"],"dc:subject":["Clinical Laboratory Sciences"],"dc:title":["Diagnostic yield of tuberculosis investigations on bone marrow biopsy samples in HIV positive patients at Groote Schuur Hospital"],"dc:type":["Thesis / Dissertation"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:23:44Z"}