P160 Outcomes of New Entrant Latent Tuberculosis Screening Programme in Secondary care setup

SUMMARYThe screening and treatment of latent tuberculosis infection (LTBI) to prevent active tuberculosis (TB) is recommended by the WHO in all HIV-infected patients. The aim of this study was to evaluate its implementation within Belgium's HIV care. A multiple-choice questionnaire was sent to 55 physicians working in the country's AIDS reference centres. Response rate reached 62%. Only 20% screened all their HIV-infected patients for LTBI. Screening methods used and their interpretation vary from one physician to another. The main barriers to the implementation of LTBI screening and treatment, as perceived by the participants, are lack of sensitivity of screening tools, risks associated with polypharmacy and toxicity of treatment. The poor coverage of LTBI screening reported here and the inconsistency in methods used raises concern. However, this was not unexpected as, in low-TB incidence countries, who, when and how to screen for LTBI remains unclear and published guidelines show important disparities. Recently, a targeted approach in which only HIV-infected patients at highest risk of TB are screened has been suggested. Such a strategy would limit unnecessary exposure to LTBI treatment. This methodology was approved by 80% of the participants and could therefore achieve greater coverage. Its clinical validation is still pending.

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AB0570 Different cut off of tuberculin skin test in latent tuberculosis screening in systemic lupus erythematosus, rheumatoid arthritis and ankylosing spondylitis with an intermediate tuberculosis burden population

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2013-eular.2892 ◽

2013 ◽

Vol 72 (Suppl 3) ◽

pp. A963.3-A964

Author(s):

Y.-J. Jan Wu ◽

Y.-C. Liu ◽

S.-C. Chen

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Ankylosing Spondylitis ◽

Tuberculin Skin Test ◽

Skin Test ◽

Lupus Erythematosus ◽

Latent Tuberculosis ◽

Systemic Lupus ◽

Tuberculosis Screening

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Tuberculosis Screening and Active Tuberculosis among HIV-Infected Persons in a Canadian Tertiary Care Centre

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2009/658382 ◽

2009 ◽

Vol 20 (2) ◽

pp. 51-57 ◽

Cited By ~ 8

Author(s):

Paul Brassard ◽

Travis Salway Hottes ◽

Richard G Lalonde ◽

Marina B Klein

Keyword(s):

Highly Active Antiretroviral Therapy ◽

Tertiary Care ◽

Latent Tuberculosis ◽

Clinic Visit ◽

Skin Tests ◽

Country Of Birth ◽

Hiv Diagnosis ◽

Tertiary Care Centre ◽

Tuberculosis Screening

RATIONALE: HIV infection increases the risk of reactivation of latent tuberculosis (TB). The present study evaluates how latent TB is detected and treated to determine the effectiveness of screening in HIV-infected patients with diverse risk profiles.METHOD: A retrospective medical record database review (1988 to 2007) was conducted at a tertiary care HIV clinic. The proportion of patients receiving tuberculin skin tests (TSTs) and the rate of active TB at each stage of screening and prevention were estimated. Predictors of receiving a TST at baseline, testing positive by TST and developing active TB were evaluated.RESULTS: In the present study, 2123 patients were observed for a total of 9412 person-years. Four hundred seventy-six (22.4%) patients were tested by TST within 90 days of first clinic visit. Having a first clinic visit during the highly active antiretroviral therapy era (OR 3.64; 95% CI 2.66 to 4.99), country of birth (ORs: Africa 3.11, Asia 2.79, Haiti 3.14, and Latin America and the Caribbean 2.38), time between HIV diagnosis and first visit (OR per one-year change 0.97; 95% CI 0.94 to 0.99) and previous antiretroviral exposure (OR 0.61; 95% CI 0.45 to 0.81) were independent predictors of receiving a TST at baseline. Of the 17 patients who developed active TB during follow-up, nine (53%) had no documented TSTs at baseline or during follow-up. Forty-one per cent of all TB patients and 56% of TB patients who were not screened were born in Canada.CONCLUSION: The administration of TSTs to newly diagnosed HIV patients was inconsistent and differential according to country of birth, among other factors, resulting in missed opportunities for TB prevention.

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