Author:
Lin Kuan-Yin,Yang Chia-Jui,Sun Hsin-Yun,Lee Yuan-Ti,Liou Bo-Huang,Hii Ing-Moi,Chen Tun-Chieh,Huang Sung-Hsi,Lee Chun-Yuan,Tsai Chin-Shiang,Lin Chi-Ying,Liu Chun-Eng,Chang Hsi-Yen,Cheng Chien-Yu,Lu Po-Liang,Hung Chien-Ching,Huang Yu-Shan,Liu Wang-Da,Chen Guan-Jhou,Liu Wen-Chun,Su Yi-Ching,Wu Pei-Ying,Chen Ling-Ya,Zhang Jun-Yu,Tsai Mao-Song,Lin Chia-Chun,Lee Yu-Lin,Chen Yen-Hsu,Huang Yi-Chia,Ko Wen-Chien,Cheng Shu-Hsing,Chang Sui-Yuan,Wang Ning-Chi,Lin Te-Yu,Lee Yi-Chieh,Lin Shih-Ping,Hsieh Chia-Yin,Wang Hsiu-Wen,Ho Mao-Wang,Hung Tung-Che,Tsai Hung-Chin,Lin Hsi-Hsun,Lee Chen-Hsiang,
Abstract
AbstractTesting and treatment of tuberculosis infection (TBI) are recommended for people living with HIV (PLWH). We aimed to evaluate the care cascade of TBI treatment among PLWH in the era of antiretroviral therapy (ART) scale-up. This retrospective study included adult PLWH undergoing interferon-gamma release assay (IGRA)-based TBI screening during 2019–2021. PLWH testing IGRA-positive were advised to receive directly-observed therapy for TBI after active TB disease was excluded. The care cascade was evaluated to identify barriers to TBI management. Among 7951 PLWH with a median age of 38 years and CD4 count of 616 cells/mm3, 420 (5.3%) tested positive and 38 (0.5%) indeterminate for IGRA. The TBI treatment initiation rate was 73.6% (309/420) and the completion rate was 91.9% (284/309). More than 80% of PLWH concurrently received short-course rifapentine-based regimens and integrase strand transfer inhibitor (InSTI)-containing ART. The main barrier to treatment initiation was physicians’ concerns and patients’ refusal (85.6%). The factors associated with treatment non-completion were older age, female, anti-HCV positivity, and higher plasma HIV RNA. Our observation of a high TBI completion rate among PLWH is mainly related to the introduction of short-course rifapentine-based regimens in the InSTI era, which can be the strategy to improve TBI treatment uptake.
Publisher
Springer Science and Business Media LLC
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