Latent tuberculosis screening and treatment in HIV: highly acceptable in a prospective cohort study

Abstract

BackgroundPeople living with HIV (PLWH) are at increased risk of reactivation of latent TB infection (LTBI). Although UK and international guidelines identify this group as a priority for LTBI screening and treatment, data on attitudes of PLWH to this policy recommendation are lacking.MethodsA five-point, Likert-style questionnaire was administered to PLWH to assess views and intentions towards accepting LTBI screening and treatment. Subsequent Immune Gamma Release Assay (IGRA) testing was offered, and chemoprophylaxis if required. Influencing demographic and psychological associations with planned, and actual, testing and treatment uptake, were assessed using multivariable logistic regression.Results444/716 (62%) patients responded. 417/437 (95.4%) expressed intention to accept LTBI testing. The only significant association was the perceived importance of testing to the individual (aOR 8.98, 95% CI 2.55–31.67). 390/393 (99·2%) accepted appropriate IGRA screening; 41/390 (10·5%) were positive. 397/431 (92.1%) expressed intention to accept chemoprophylaxis, associated with perceived importance of treatment (aOR 3.52, 95% CI 1.46–8.51), a desire to have treatment for LTBI (aOR 1.77, 95% CI 0.99–3.15), and confidence in taking treatment (aOR 3.77, 95% CI 1.84–7.72). Of those offered chemoprophylaxis, 36/37 (97·3%) accepted and 34/36 (94·4%) completed treatment. There were no correlates with actual screening acceptance.ConclusionsLTBI is common amongst PLWH, highlighting the importance of robust screening and treatment programmes. This study shows that screening and treatment for LTBI is highly acceptable to PLWH and provides strong, objective, evidence for policy-makers developing guidelines in this cohort.

Pengetahuan, Sikap dan Dukungan Keluarga terhadap Niat Memeriksakan Dahak pada Presumtif TBC

“…Hasil penelitian yang telah dilakukan sesuai dengan Teori Planned Behavior bahwa dukungan keluarga dapat mempengaruhi persepsi individu terkait keyakinan individu bahwa suatu individu lain atau kelompok akan menerima atau tidak menerima tindakan atau perilaku kesehatan yang akan dia lakukan. Dukungan keluarga ini termasuk bentuk keyakinan normatif yang dapat menentukan norma subjektif seseorang (White et al, 2022).…”

The impact, effectiveness and outcomes of targeted screening thresholds for programmatic latent tuberculosis infection testing in HIV

“…This contradictory guidance may have contributed to the extreme heterogeneity in how LTBI testing for PWH is applied in the UK. Our national evaluation of practice highlighted that no widespread LTBI programmatic screening has been implemented in the UK in this population, with approximately half of HIV services offering no LTBI testing [15] despite LTBI screening and treatment being highly acceptable to this population [16]. Reasons for this heterogeneity in screening practice remain unclear but it likely represents a lack of confidence in existing guidelines and uncertainty as to which individuals should be offered LTBI screening.…”