Latent tuberculosis infection screening in <scp>HIV</scp>‐infected patients: guidelines versus everyday practice in a <scp>UK HIV</scp> centre

Aston, Stephen; Doherty, Katie; Black, Brad; Davies, Geraint R.

doi:10.1111/hiv.12678

Cited by 1 publication

(2 citation statements)

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“…To assess LTBI prevalence, we included 39 cohort studies [10,18–55] and 12 cross-sectional studies [56–67], with a total of 65 930 PWH, as summarized in Table 1. Studies were published after 1991; they were conducted in Canada, the United States, Australia, New Zealand, and several Western and Southern European countries.…”

Section: Resultsmentioning

confidence: 99%

“…LTBI screening was performed less often among those on successful ART [ 68 ]. Median baseline CD4 + cell counts, reported in 16 of 22 studies, ranged from 272 [ 23 ] to 648 [ 56 ] at enrolment; six studies reported proportions of those with less than 200 CD4 + cells, ranging from 25% [ 21 ] to 48% [ 45 ]. Median plasma HIV-RNA (reported in 14 studies) ranged from less than 50 copies/ml [ 29 , 53 ] to 4.9 log 10 copies/ml [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

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Screening for tuberculosis infection and effectiveness of preventive treatment among people with HIV in low-incidence settings

van Geuns,

Arts,

de Vries

et al. 2023

Aids

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To determine the yield of screening for latent tuberculosis infection (LTBI) among people living with HIV (PLHIV) in low tuberculosis (TB) incidence countries (<10 TB cases per 100.000 persons), we performed a systematic review and meta-analysis to assess prevalence and predictive factors of LTBI, rate of TB progression, effect of TB preventive treatment (TPT), and numbers needed to screen. Pubmed and Cochrane Library were searched for studies reporting primary data, excluding studies on active or pediatric TB. We extracted LTBI cases, odds ratios, and TB incidences; pooled estimates using a random-effects model; and used the Newcastle-Ottawa scale for bias. In 51 studies with 65.930 PLHIV, 12% (95% CI 10–14) had a positive LTBI test, which was strongly associated with origin from a TB-endemic country (OR 4.7) and exposure to TB (OR 2.9). Without TPT (10,629 PLHIV), TB incidence was 28/1000 person years (PY; 95% CI 12–45) for LTBI-test positive versus 4/1000 PY (95% CI 0–7) for LTBI-test negative individuals. Among 625 PLHIV (1644 PY) receiving TPT, 15 developed TB (6/1000 PY). An estimated 20 LTBI-positive individuals would need TPT to prevent one case of TB, and numbers needed to screen to detect LTBI or prevent active TB varied according to a priori risk of LTBI. The relatively high prevalence of LTBI among PLHIV and the strong correlation with origin from a TB-endemic country support risk-stratified LTBI screening strategies for PLHIV in low-incidence countries and treating those who test positive.

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Section: Resultsmentioning

confidence: 99%