Trial results showcased today at the Stephen Lawn Memorial Lecture show that a urine test for tuberculosis (TB) resulted in reduced mortality and an increase in TB diagnosis among people living with HIV who are admitted to hospital.
Elizabeth Corbett, Prof of Tropical Epidemiology, delivered the lecture at the London School of Hygiene and Tropical Medicine, sharing results from the STAMP trial of urinary TB diagnostics.
The currently used sputum and x-ray screening for TB relies on an individual’s immune system working well enough to show the signs of TB that the tests look for, which can be extremely challenging for those living with HIV whose immune systems are often weakened. It can mean that those living with HIV can be less likely to be diagnosed with TB, when they are in fact the patients most at risk of death from TB (40 percent of all HIV deaths in 2016 were from TB).
The STAMP trial, which Professor Stephen Lawn was integral in establishing, recruited 2,600 patients in Malawi and South Africa and used urine-based tests with a sputum test to screen for TB. The LAM urine test costs between US$2 and US$3 and can be done at the bedside.
The results show that patients in the urine-tested arm of the trial were less likely to die within two months than those in the arm with just the sputum test. The results also showed an increase in diagnosis – for every 100 patients screened the urine-test resulted in an extra seven TB cases being diagnosed.
Dr Corbett said; “The main impact of the results in many ways is that it means a patient is more unlikely to be discharged without TB treatment than would have been the case previously.”
The lecture is part of the Stephen Lawn Memorial Fund for TB and AIDS Research Leadership, that was set up to commemorate his life and work and to inspire the next generation of TB researchers. The fund is managed by the TB Centre at the London School of Hygiene and Tropical Medicine, The Union, and the Desmond Tutu HIV Centre in Cape Town.
Each year the fund also supports a prize for an upcoming researcher conducting promising work focused on reducing the disease burden of TB and HIV/AIDS in Africa. The first prize was awarded at The Union World Conference on Lung Health to Dr Leonardo Martinez, who attended today’s lecture and will be featured in a Lancet profile piece this week. Nominations for the 2018 Stephen Lawn Prize are open until 30 March.
Professor Stephen Lawn was a leading specialist in HIV and TB and is greatly missed following his death from a cerebral tumour in September 2016. Professor Joy Lawn, Professor Stephen Lawn’s wife, closed the lecture saying:
“Most of all Steve loved a good communication – to laugh, cry and do something different in science afterwards.
“It’s not just about the science, but it’s about communicating that science.”
The fund was set up as a comfort to Steve, but it’s been a huge comfort to me. It’s what he believed in and it will go on because of this lecture and the prize. Please let us really carry this flame forward.