comparison of diagnostic value between lipoarabinomannan test and gene xpert mtb/rif ultra for diagnosis of pulmonary tuberculosis in urine hiv patients

Hiv is an infection that attacks the immune system, especially cd4 cells, making them more susceptible to infections, such as tuberculosis (tb). some laboratory examination methods used to diagnose pulmonary tuberculosis such as microscopic examination, polymerase-chain-reaction (pcr), and culture. all of these methods use sputum samples while suspected pulmonary tb hiv-aids patient have difficulty producing good sputum, so other samples such as urine are needed as an alternative. this study aims to compare the diagnostic value of urine lipoarabinomannan test and genexpert mtb/rif ultra urine to diagnose of pulmonary tuberculosis in hiv patients. this cross-sectional study is using urine specimens from hiv patients with pulmonary tb and without pulmonary tb at dr. soetomo general hospital in may-september 2024. urine lipoarabinomannan test and genexpert mtb/rif ultra urine were performed at clinical pathology laboratory. diagnostic values and kappa index were analysed using spss 24.0 software. the diagnostic value of urine lipoarabinomannan test is better than urine genexpert mtb/rif ultra, with (67% sensitivity; 95% specificity vs. 26.19% sensitivity; 100% specificity). the suitability analysis of the urine lipoarabinomannan test with the sputum genexpert mtb/rif for diagnosing pulmonary tuberculosis in hiv patients showed better results than the urine genexpert mtb/rif ultra. urinary lipoarabinomannan testing has increasing diagnostic value in cd4 <200 cells/mm3 hiv patients. the diagnostic value analysis of the urine lipoarabinomannan test is better than genexpert mtb/rif ultra urine. therefore, it can be used as an additional diagnostic tool for diagnosing pulmonary tb, especially for hiv patients.