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ATS guide addresses HIV, molecular probes
A reference document used to diagnose TB by nurses, physicians who don’t see the illness on a regular basis, and international health care providers has been updated and should be available by the end of the year.
One of the changes in "Diagnostic Standards and Classification of Tuberculosis in Adults and Children" is reflected in the name, which until this year didn’t make any reference to kids. "It should have included children in the past — they get TB, too — but it didn’t because, historically, the American Thoracic Society [ATS] has been made up of mostly internists who don’t take on children," explains Nancy Dunlap, MD, PhD. Dunlap is a medical consultant to Alabama’s TB control program and chair of the ATS statements committee that has retooled the document.
Other changes are just as pertinent. Since the document was last revised in 1990, HIV disease has arisen to change the face of TB. In addition, new technologies involving molecular-based tests have changed the way laboratories diagnose TB.
The document has taken a relatively conservative stance on the new array of molecular tests available because some of the applications are still being worked out, Dunlap says. "For example, we talk about the Gen-Probe test (see story, p. 91), but we stress that it’s still not clear how it will be used for smear-negative specimens. We’ve also added a little more about how you use molecular genotyping, and we’ve provided references for all that new information."
According to the ATS, the new document should be printed by the end of the year.