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Diagnosis and management of TB
P54 Testing For Blood Borne Viruses in a TB Clinic: Why Discriminate on the Basis of Who Gets TB Treatment?
  1. TP Cusack1,
  2. J Sewell2,
  3. S Chaytor1,
  4. J Johnson1,
  5. A Solamalai1,
  6. P MacKenzie1,
  7. A Goodburn1,
  8. S Hopkins1,
  9. I Cropley1,
  10. M Lipman1
  1. 1Royal Free London NHS Foundation Trust, London, United Kingdom
  2. 2University College London, London, United Kingdom

Abstract

Introduction Testing for blood borne viruses (BBV), in particular HIV, is a standard of care for people on active tuberculosis (TB) treatment. Although individuals with latent TB infection and those with suspected TB disease are drawn from similar populations, with presumably similar risks for BBV, there are little reported data on this. Our TB clinic has a policy of routine testing for HIV, Hepatitis B (HBV) & Hepatitis C (HCV) on those with a diagnosis of active and latent TB. Here we review our data.

Methods Information on all adults attending TB services between 01/01/2009 and 19/07/2012 at our centre (apart from those known to be HIV infected at the time of TB service encounter) were extracted from hospital clinical and pathology information systems.

Results 1656 subjects were seen (Active TB: 22%, Latent TB: 11%, Other final diagnosis not TB: 67%). 748 (45%) had all three BBV tests performed. This was significantly different between the groups, as subjects with either latent or active TB were more likely to have all three tests (Active: 90%, Latent: 83% vs Other diagnosis: 24%, P<0.001). In those tested, an HIV positive result was more frequently found in active TB (7.5%), whilst the HIV prevalence was similar in the two other groups (Latent 1.3% vs Other 1.4%). HBV was more common in Active & Latent TB populations compared to the Others (3% vs 0.8%, P<0.001). HCV had a similar prevalence pattern to HIV, in that it was more common in those with Active TB (3% vs Latent TB: 0.6%, Other 1%, P= 0.06).

Conclusion We find a high rate of uptake for HIV, HBV & HCV testing in our subjects treated for active and latent TB. HIV & HCV were more common in the former population. Adults with latent TB had a similar prevalence of HIV and HCV to those subjects whose final diagnosis was other than TB. However, the latter had a much lower overall uptake of BBV testing. This is of concern and suggests that we are missing opportunities to diagnose unsuspected BBV infection in a large number of clinic attendees.

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