Received by the Editorial Office: 12.06.2026
Accepted for publication: 26.06.2026
Published online: 30.06.2026
UDC: 616-002.5-07-074:616.98:578.828:616.94(048.8)
DOI: 10.26212/2227-1937.2026.23.75.004
DIAGNOSTIC VALUE OF THE LAM TEST FOR MYCOBACTERIEMIA IN HIV PATIENTS/TB SEPSIS (LITERATURE REVIEW)
Muzdubayeva B.T.1
National Scientific Center of Phthisiopulmonology of the Republic of Kazakhstan, Almaty, Kazakhstan
Objective. The mortality rate in combination with tuberculosis (TB), HIV infection and sepsis is extremely high and ranges from 30% to 40% even against the background of the use of modern antimicrobial drugs. The rapid development of the disease occurs within only 10-30 days. The mortality rate at the immediate (empirical) start of standard TB treatment is 12%.
In cases of severe course, Mycobacterium tuberculosis becomes the main pathogen causing sepsis in such patients. Mycobacteriemia is a direct trigger and leading etiological factor in the development of severe sepsis and septic shock in patients with severe immunodeficiency (especially against the background of HIV infection with CD4 levels < 100 cells/µl. Full-scale clinical studies (for example, ATLAS, 2026) confirm that Mycobacterium tuberculosis is found in the blood of more than 52% of patients with HIV-associated sepsis, acting as the main latent pathogen. The high mortality rate of HIV/Tb patients from sepsis dictates the need to introduce rapid diagnostic methods. A promising solution to this problem is the loop isothermal amplification method (LAM test), which combines high speed and accessibility. Materials and Methods. The article is written taking into account the results of the review of scientific literature. The article uses scientific approaches and a set of methods, including clinical and epidemiological analyses. The article included randomized trials, cross-sectional and observational cohort studies evaluating the effectiveness of LF-LAM for the diagnosis of active tuberculosis (pulmonary and extrapulmonary), tuberculosis sepsis in HIV-positive adults.
Results. Studies show that the sensitivity of the test directly depends on the immune status.: it is maximal at CD4 levels <50 cells/µl (up to 75-90%). If sputum microscopy is negative, the LF-LAM test can detect tuberculosis in an additional 25% of cases in people with severe immunosuppression. A positive result of LF-LAM in 99.4% of cases is confirmed by a diagnosis of tuberculosis or mycobacteriosis. In WHO clinical guidelines and national guidelines, the LAM test in urine (especially LF-LAM) is positioned solely as a rapid screening tool to reduce mortality among vulnerable groups, rather than as a marker of a specific clinical syndrome. Discussion. The course of tuberculous sepsis is characterized by rapidity (manifestation in 10-30 days) and atypical symptoms, which is why it is often confused with banal bacterial sepsis or typhoid fever. With HIV infection (especially at the stage of AIDS with CD4+ lymphocyte count less than 200 cells / µl), tuberculous sepsis occurs in the form of generalized hematogenous tuberculosis, which in medicine is classified as acute tuberculous sepsis (historical name — typhobacillosis Landuzi. A positive result of the LAM test is a direct reason for the immediate start of treatment for tuberculosis and sepsis, without waiting for the results of the sowing. The generalization of the tuberculosis process is accompanied by the release of the antigen into the bloodstream and subsequent filtration into the urine, which makes this test a marker of disseminated tuberculosis. A negative test does not exclude TB by 100%, therefore, if clinical suspicions persist, other studies (sputum PCR, crops) should be continued.
Conclusions. The TV-LAM test is a fast, specific and easy-to-perform research method for detecting active mycobacterial infection in HIV-infected patients at the stage of immunodeficiency, especially with CD4+T lymphocytes <100 cells/ml. This diagnostic method makes it possible to identify mycobacterimemia in the early stages of hospitalization, minimizing the length of stay of such patients in a non-core hospital and shortening the time before the appointment of etiotropic therapy. Keywords: HIV infection, tuberculosis, LAM test, sepsis.
