Prevalence of latent tuberculous infection among HIV-infected patients in a Dutch out-patient clinic

In Reply: Latent tuberculous infection testing among HIV-infected persons in clinical care

“…Although prior testing data are not presented, the study by van Bentum et al achieved LTBI testing results using an IGRA in 599 (80.7%) of 742 PLHIV during an 18-month study period. 5 Only 19% of PLHIV in our study were tested by an IGRA over a 5-year study period; an additional 2.7% of PLHIV would potentially have an LTBI test result had they been tested by IGRA instead of TST.…”

“…4 While testing for LTBI among PLHIV in the Netherlands is not routine, the study by van Bentum et al observed positive LTBI test results among 4.8% of their study population, highlighting the critical importance of screening PLHIV. 5 Evidence supporting annual TB testing among PLHIV who are at continued high risk of exposure is limited to expert opinion and clinical experience. Our analysis identified characteristics of PLHIV that providers can use to inform the decision regarding annual, targeted testing for LTBI.…”

“…The Dutch study found African origin to be significantly associated with LTBI in their population. 5 We recommend that providers periodically evaluate risk for exposure to and transmission of M. tuberculosis, particularly if individual patients develop new risk factors.…”

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

“…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.…”

“…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 ].…”