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Introduction People living with HIV (PLWH) are at high risk of active tuberculosis (TB) but this risk in the era of antiretroviral treatment (ART) remains unclear. It is critical to identify the groups who should be prioritised for latent TB (LTBI) screening. In this study we identified the risk factors associated with developing incident TB disease, by analysing a 30‐year observational cohort. Methods We evaluated PLWH in Leicester, UK, between 1983 and 2017 to ascertain those who developed active TB and the timing of this in relation to HIV diagnosis; whether before, concurrently with, or more than 3 months after the diagnosis of HIV (incident TB). Predictors of incident TB were ascertained using Cox proportional hazards models. Results In all, 325 out of 2158 (15.1%) PLWH under care had had active TB; 64/325 (19.7%) prior to HIV diagnosis, 161/325 (49.5%) concurrently with/within 3 months of HIV diagnosis and 100/325 (30.8%) had incident TB. Incident TB risk was 4.57/1000 person‐years. Increased TB incidence in the country of birth was associated with an increased risk of developing incident TB [50–149/100 000 population, adjusted hazard ratio (AHR) = 3.10, 95% CI: 0.94–10.20; 150–249/100 000 population, AHR = 7.14, 95% CI: 3.46–14.74; 250–349/100 000 population, AHR = 5.90, 95% CI: 2.32–14.99; ≥ 350/100 000 population, AHR = 3.96, 95% CI: 1.39–11.26]. Conclusions Tuberculosis risk remains high among PLWH and is related to TB incidence in the country of birth. Further work is required to determine whether specific groups of PLWH should be targeted for programmatic LTBI screening, and whether it will result in high uptake and completion of chemoprophylaxis and is cost‐effective for widespread implementation.

BackgroundVaccine uptake data is automatically extracted from all GP practices in England via the web-based reporting system, ImmForm, on behalf of Public Health England. In 2016/17, an Uptake Summary Tool was introduced on ImmForm for practice managers, clinical commissioning groups (CCGs) and screening and immunisation teams (SCRIMMS) to help facilitate local and regional management of the influenza programme. The tool allows practices to view and evaluate influenza uptake rates by target cohorts, comparing them against the previous season and CCG average/overall national uptake each week.AimTo assess how many practices use the Uptake Summary Tool and whether there is a difference in vaccine uptake among practices that use the tool compared with those that don’t during the 2016/17 and 2017/18 influenza seasons.MethodPractice level use of the Uptake Summary Tool was examined for the 2016/17 influenza season and vaccine uptake compared between practices that used the tool and those that did not.ResultsAn average of 1272 practices used the tool each week during the 2016/17. Vaccine uptake was on average 2.9% greater for targeted cohorts in practices that used the tool than practices that did not during the 2016/17 season.ConclusionWhen used on a regular basis the Uptake Summary Tool can help GP practices, CCGs and SCRIMMS monitor vaccine and may be associated with increased vaccine uptake. Uptake for the 2017/18 season will be monitored and assessed throughout the current season. We aim to expand the tool to other vaccine collections in the near future.