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.

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 yield of the screening for latent tuberculosis infection (LTBI) in newly-diagnosed PLWH, offer of preventive therapy to LTBI-individuals, and completion rate.

MATERIALS/METHODS

We retrospectively (2016/2017) evaluated newly-diagnosed PLWH in 9 centres, using binary and multinomial logistic regressions to identify factors associated with LTBI diagnostic screening and QuantiFERON (QFT) results.

RESULTS

Of 801 patients evaluated, excluding active TB, 774 were studied. LTBI tests were performed in 65.5%. Prescription was associated with being foreign-born (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 CD4 ≥ 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 cell/mm3 increments RRR 1.26, p < 0.003). Sixteen LTBI-individuals started TB-preventive therapy and 8 completed it.

CONCLUSIONS

LTBI screening is inconsistently performed in newly-diagnosed PLWH, TB-preventive therapy is not offered to all LTBI-individuals and compliance is poor.