On World AIDS day, the WHO Department of HIV/AIDS and the Stop TB Department issued new guidelines showing how people with HIV can be protected from tuberculosis with regular and low-cost preventive medication. This holds great promise for people living with HIV because TB is still the leading cause of death in people living with HIV, accounting for more than a quarter of AIDS deaths worldwide. The guidelines entitled “Guidelines for intensified tuberculosis case-finding and isoniazid preventive therapy for people living with HIV in resource-constrained settings” will help reduce TB disease not only in people with HIV but also within families and communities.
The final recommendations took into consideration many factors including quality of evidence, cost, feasibility, and values and preferences of the community and health-care workers. Key aspects of the new guidelines include:
- A simplified screening algorithm that identifies those eligible for either isoniazid preventative therapy (IPT) or further diagnostic work-up for TB and other conditions.
- Chest radiography is no longer mandatory for initiation of IPT.
- The tuberculin skin test (TST) is not required for the initiation of IPT in people living with HIV. TST can still be used in indentifying persons that may benefit from IPT.
- Strongly recommends at least 6 months of IPT for children and adults including pregnant women, people living with HIV, and those receiving anti-retroviral therapy, and those who have successfully completed TB treatment.
- Conditionally recommends IPT for 36 months in setting with high transmission of TB among people living with HIV.
- IPT should be viewed as part of a prevention package for people living with HIV.
The full report can be found by clicking here.
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