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dc.contributor.authorPareek, Manish
dc.date.accessioned2023-11-29T10:13:46Z
dc.date.available2023-11-29T10:13:46Z
dc.date.issued2023-10-12
dc.identifier.citationvan Geuns, D., Arts, R. J., de Vries, G., Wit, F. W., Degtyareva, S. Y., Brown, J., Pareek, M., Lipman, M., & van Crevel, R. (2023). Screening for tuberculosis infection and effectiveness of preventive treatment among people living with HIV in low-incidence settings: a systematic review and meta-analysis. AIDS (London, England), 10.1097/QAD.0000000000003747. Advance online publication. https://doi.org/10.1097/QAD.0000000000003747en_US
dc.identifier.other10.1097/QAD.0000000000003747
dc.identifier.urihttp://hdl.handle.net/20.500.12904/17929
dc.description.abstractTo determine the yield of screening for latent tuberculosis infection (LTBI) among people living with HIV (PLHIV) in low tuberculosis (TB) incidence countries (<10 TB cases per 100.000 persons), we performed a systematic review and meta-analysis to assess prevalence and predictive factors of LTBI, rate of TB progression, effect of TB preventive treatment (TPT), and numbers needed to screen. Pubmed and Cochrane Library were searched for studies reporting primary data, excluding studies on active or pediatric TB. We extracted LTBI cases, odds ratios, and TB incidences; pooled estimates using a random-effects model; and used the Newcastle-Ottawa scale for bias. In 51 studies with 65.930 PLHIV, 12% (95% CI 10-14) had a positive LTBI test, which was strongly associated with origin from a TB-endemic country (OR 4.7) and exposure to TB (OR 2.9). Without TPT (10,629 PLHIV), TB incidence was 28/1000 person years (PY; 95% CI 12-45) for LTBI-test positive versus 4/1000 PY (95% CI 0-7) for LTBI-test negative individuals. Among 625 PLHIV (1644 PY) receiving TPT, 15 developed TB (6/1000 PY). An estimated 20 LTBI-positive individuals would need TPT to prevent one case of TB, and numbers needed to screen to detect LTBI or prevent active TB varied according to a priori risk of LTBI. The relatively high prevalence of LTBI among PLHIV and the strong correlation with origin from a TB-endemic country support risk-stratified LTBI screening strategies for PLHIV in low-incidence countries and treating those who test positive.
dc.description.urihttps://journals.lww.com/aidsonline/abstract/9900/screening_for_tuberculosis_infection_and.363.aspxen_US
dc.language.isoenen_US
dc.subjectlatent tuberculosis infection (LTBI)en_US
dc.subjectHIV (PLHIV)en_US
dc.subjectlow tuberculosis (TB) incidenceen_US
dc.titleScreening for tuberculosis infection and effectiveness of preventive treatment among people living with HIV in low-incidence settings: a systematic review and meta-analysisen_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionNAen_US
rioxxterms.versionofrecordhttps:/doi.org/10.1097/QAD.0000000000003747en_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.panelUnspecifieden_US
html.description.abstractTo determine the yield of screening for latent tuberculosis infection (LTBI) among people living with HIV (PLHIV) in low tuberculosis (TB) incidence countries (<10 TB cases per 100.000 persons), we performed a systematic review and meta-analysis to assess prevalence and predictive factors of LTBI, rate of TB progression, effect of TB preventive treatment (TPT), and numbers needed to screen. Pubmed and Cochrane Library were searched for studies reporting primary data, excluding studies on active or pediatric TB. We extracted LTBI cases, odds ratios, and TB incidences; pooled estimates using a random-effects model; and used the Newcastle-Ottawa scale for bias. In 51 studies with 65.930 PLHIV, 12% (95% CI 10-14) had a positive LTBI test, which was strongly associated with origin from a TB-endemic country (OR 4.7) and exposure to TB (OR 2.9). Without TPT (10,629 PLHIV), TB incidence was 28/1000 person years (PY; 95% CI 12-45) for LTBI-test positive versus 4/1000 PY (95% CI 0-7) for LTBI-test negative individuals. Among 625 PLHIV (1644 PY) receiving TPT, 15 developed TB (6/1000 PY). An estimated 20 LTBI-positive individuals would need TPT to prevent one case of TB, and numbers needed to screen to detect LTBI or prevent active TB varied according to a priori risk of LTBI. The relatively high prevalence of LTBI among PLHIV and the strong correlation with origin from a TB-endemic country support risk-stratified LTBI screening strategies for PLHIV in low-incidence countries and treating those who test positive.en_US
rioxxterms.funder.project94a427429a5bcfef7dd04c33360d80cden_US


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