Purpose of review Urine
is increasingly being investigated as a convenient clinical sample for the identification of mycobacterial products for the diagnosis
. The available literature on mycobacterial lipoarabinomannan
(LAM) and urine mycobacterial DNA
The available data, despite being extracted from heterogeneous clinical populations and different clinical subgroups, indicate that urine
LAM has little diagnostic utility in unselected tuberculosis
suspects; however, test characteristics improve in HIV-infected patients, particularly those with advanced immunosuppression (CD4 cell count <200 cells/μl). Methodologies for urine PCR
for detection of mycobacterial DNA
vary across studies and focus is on standardizing assays with respect to specimen collection, assay design, and processing methodology.
Both the urine
LAM and PCR
for mycobacterial DNA
are being evaluated in different geographical settings. Urine
LAM currently offers little utility for the diagnosis
in unselected populations. However, urine
LAM appears promising as a diagnostic tool in HIV-infected patients with CD4 cell counts less than 200 cells/μl in different clinical settings. Further developmental studies are required to enhance the performance of the assays, and their usefulness over sputum microscopy in HIV-infected patients with advanced immunosuppression requires definition in large cohort studies.