Bibliographic Info
Recommendation
Recommended against
Conditional
Certainty of evidence
Very low
In outpatient settings, WHO recommends against using lateral flow urine lipoarabinomannan assay (LF-LAM) to assist in the diagnosis of active TB in HIV-positive adults, adolescents and children: without TB symptoms and witha CD4 cell count of 100–200
Notes and Remarks
a. The reviewed evidence and recommendations apply to the use of AlereLAM only, because other in-house LAM-based assays have not been adequately validated or used outside limited research settings. Any new or generic LAM-based assay should be subject to adequate validation in the settings of intended use. b. All patients with signs and symptoms of pulmonary TB who are capable of producing sputum should have as their initial diagnostic test at least one sputum specimen submitted for Xpert® MTB/RIF (Ultra) assay. This also includes children and adolescents living with HIV who are able to provide a sputum sample. c. These recommendations also apply to adolescents and children living with HIV, based on generalization of data from adults, while acknowledging very limited data for these population groups. d. LF-LAM should be used as an add-on to clinical judgement in combination with other tests. It should not be used as a replacement or triage test. More details are given in Annex 1. Algorithms for LF-LAM use.
Also Featured In
This recommendation also appears in the following guidelines:
Lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis of active tuberculosis in people living with HIV: policy update 2019
WHO consolidated guidelines on tuberculosis: module 3: diagnosis – rapid diagnostics for tuberculosis detection: web annex 2. GRADE profiles
WHO consolidated guidelines on tuberculosis: module 3: diagnosis – rapid diagnostics for tuberculosis detection: web annex 2. GRADE profiles
WHO consolidated guidelines on tuberculosis: module 6: tuberculosis and comorbidities.
WHO consolidated guidelines on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection, 3rd ed.
WHO consolidated guidelines on tuberculosis: module 6: tuberculosis and comorbidities, 2nd ed.