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Latent tuberculosis infection screening and treatment in HIV: insights from evaluation of UK practice
  1. Helena A White1,2,
  2. Robert F Miller3,
  3. Anton L Pozniak4,
  4. Marc C I Lipman5,
  5. Iain Stephenson1,
  6. Martin J Wiselka1,2,
  7. Manish Pareek1,2
  1. 1 Department of Infection and Tropical Medicine, Leicester Royal Infirmary, Leicester, UK
  2. 2 Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
  3. 3 Research Department of Infection and Population Health, University College London, London, UK
  4. 4 HIV Department, Chelsea and Westminster Hospital, London, UK
  5. 5 UCL Respiratory, Division of Medicine, University College London, London, UK
  1. Correspondence to Dr Manish Pareek, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester LE1 5WW, UK; mp426{at}le.ac.uk

Abstract

Latent TB infection (LTBI) screening and treatment in HIV-positive individuals in the UK is advocated by the British HIV Association (BHIVA) and National Institute for Health and Care Excellence (NICE), although each recommends differing strategies. We undertook an evaluation of UK practice, relating the responses to the local HIV/TB disease burden. 162 of 188 (86%) UK geographical areas responded; only 93/162 (57.4%) offer LTBI testing with considerable heterogeneity in practice, and no difference in HIV/TB burden between areas offering testing and those who do not. Only 33/93 (35.5%) and 6/93 (6.5%) reported full compliance with BHIVA and NICE guidance respectively. A uniform national guideline is required.

  • Tuberculosis

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Footnotes

  • Contributors The survey was conceptualised by HAW and MP. HAW designed the survey tool, undertook it in entirety, and the results were collated by HAW and MP but interpreted by all authors. HAW wrote the first draft, but all authors critiqued and adjusted the paper and agreed the final draft.

  • Funding HAW received a Research Award from Gilead/British HIV Association, (awarded in 2013). This report is independent research supported by the National Institute for Health Research (NIHR Post-Doctoral Fellowship, Dr Manish Pareek, PDF-2015-08-102). The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the National Institute for Health Research or the Department of Health.

  • Competing interests ALP reports being the Chair of BHIVA HIV/TB guidelines committee and a member of BTS joint committee on TB. RFM reports personal fees from Merck, personal fees from ViiV, personal fees from Gilead and personal fees from Janssen, all outside the submitted work. He is coauthor of the BHIVA HIV/TB Guidelines 2011 and additionally is a member of the BHIVA HIV/TB Guidelines 2016 writing group.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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