Latent tuberculosis infection screening in persons newly-diagnosed with HIV infection in Italy: A multicentre study promoted by the Italian Society of Infectious and Tropical Diseases

Delia Goletti, Assunta Navarra, Elisa Petruccioli, Claudia Cimaglia, Mirko Compagno, Gilda Cuzzi, Gabriella De Carli, Laura Fondaco, Fabio Franzetti, Alberto Giannetti, Andrea Gori, Giuseppe Lapadula, Miriam Lichtner, Claudio M. Mastroianni, Valentina Mazzotta, Nicoletta Orchi, Paolo Pavone, Daniela Piacentini, Veronica Pirriatore, Emanuele PontaliLoredana Sarmati, Anna Spolti, Evelina Tacconelli, Massimo Galli, Andrea Antinori, Andrea Calcagno, Enrico Girardi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The Italian Society of Infectious and Tropical Diseases performed a survey on the application of guidelines for the management of persons living with HIV (PLWH), to evaluate current practice and the yield of screening for latent tuberculosis infection (LTBI) in newly-diagnosed PLWH; in addition, the offer of preventive therapy to LTBI individuals and the completion rate were analysed. Materials and methods: Newly-diagnosed PLWH in nine centres were evaluated retrospectively (2016/2017) using binary and multinomial logistic regression to identify factors associated with LTBI diagnostic screening and QuantiFERON (QFT) results. Results: Of 801 patients evaluated, 774 were studied after excluding active TB. LTBI tests were performed in 65.5%. Prescription of an LTBI test was associated with being foreign-born (odds ratio (OR) 3.19, p < 0.001), older (for 10-year increments, OR 1.22, p = 0.034), and having a CD4 count <100 cells/mm3 vs ≥500 cells/mm3 (OR 2.30, p = 0.044). LTBI was diagnosed in 6.5% of 495 patients evaluated by QFT. Positive results were associated with being foreign-born (relative risk ratio (RRR) 30.82, p < 0.001), older (for 10-year increments, RRR 1.78, p = 0.003), and having a high CD4 count (for 100 cells/mm3 increments, RRR 1.26, p < 0.003). Sixteen LTBI individuals started TB preventive therapy and eight completed it. Conclusions: LTBI screening is inconsistently performed in newly-diagnosed PLWH. Furthermore, TB preventive therapy is not offered to all LTBI individuals and compliance is poor.

Original languageEnglish
Pages (from-to)1-20
Number of pages20
JournalInternational Journal of Infectious Diseases
DOIs
Publication statusE-pub ahead of print - Dec 27 2019

Keywords

  • Active TB
  • CD4 T-cells
  • HIV
  • IGRA
  • Latency
  • LTBI
  • Quantiferon
  • Tuberculosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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