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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Tuberculosis screening among HIV-infected patients: tuberculin skin test vs. interferon-gamma release assay
AIDS care, v 29(12), pp 1504-1509
01 Jan 2017
PMID: 28486818
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
National guidelines recommend screening for latent tuberculosis infection (LTBI) in all HIV-infected patients. Thus, the objective of this study was to measure protocol adherence to national guidelines regarding LTBI screening for HIV-infected patients entering care at an urban primary care clinic specializing in HIV care, identify clinical and other characteristics associated with adherence, and determine whether transitioning from the tuberculin skin test (TST) to the interferon-gamma release assay (IGRA) improved adherence. We conducted a retrospective study using protocol adherence to LTBI screening guidelines within twelve months of entering care at an HIV clinic as the primary outcome. Successful protocol adherence was defined as the placement and reading of a TST, performance of an IGRA, or a note in study clinic records documenting prior testing or treatment for tuberculosis in an outside setting. Multivariable modified Poisson regression models were used in analyses. Overall, 32% (n=118/372) of patients received LTBI screening within twelve months of entering care. Protocol adherence to LTBI screening guidelines increased from 28% to 37% following the transition from TST to IGRA screening. IGRA screening [adjusted prevalence ratio: 1.45, 95% confidence limits: (1.07, 1.96)], male sex [1.47 (1.05, 2.07)], transfer patient status [1.51 (1.05, 2.18)], and greater than one year of clinic attendance [1.62 (1.06, 2.48)] were independently associated with protocol adherence. Among patients without prior LTBI screening or treatment, patients entering the clinic in 2013 under the IGRA screening protocol were more likely to be screened for LTBI compared to patients entering under the TST screening protocol (34.3% vs. 9.7%, p<0.001). In conclusion, transitioning from TST to IGRA-based screening improved adherence to screening guidelines. However, further work on improving adherence to LTBI screening guidelines among HIV-infected patients is needed.
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Details
- Title
- Tuberculosis screening among HIV-infected patients: tuberculin skin test vs. interferon-gamma release assay
- Creators
- J. W. Adams - Brown UniversityC. J. Howe - Brown UniversityA. C. Andrews - Drexel UniversityS. L. Allen - Drexel UniversityC. Vinnard - d Public Health Research Institute, Rutgers , The State University of New Jersey , Newark , NJ , USA.
- Publication Details
- AIDS care, v 29(12), pp 1504-1509
- Publisher
- Taylor & Francis
- Number of pages
- 6
- Grant note
- K23 AI102639 / NIAID NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) K23AI102639 / NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]
- Web of Science ID
- WOS:000414801300006
- Scopus ID
- 2-s2.0-85019116640
- Other Identifier
- 991019167898104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Health Policy & Services
- Psychology, Multidisciplinary
- Public, Environmental & Occupational Health
- Respiratory System
- Social Sciences, Biomedical