Guidelines for intensified tuberculosis case-finding and isoniazid ...

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Contents Abbreviations and acronyms Executive summary 1. Background and process 1.1 Background 1.2 Target audience 1.3 Scope 1.4 Process of formulating the guidelines 1.5 Strength of recommendations 1.6 Adaptation of the guidelines 2. Intensified case-finding for and prevention of tuberculosis in adults and adolescents living with HIV 2.1 Screening for TB 2.2 Efficacy, regimen and duration 2.2.1 Efficacy 2.2.2 Regimen and duration 2.2.2.1 Table 1: Comparison of the efficacy of different drug regimens 2.2.3 Immune status and concomitant use of IPT with ART 2.2.4 Pregnant women 2.2.5. Patients previously treated for TB (secondary prophylaxis) 2.2.6 Special populations 2.2.7 Figure 1. Algorithm for TB screening in adults and adolescents living with HIV in HIV-prevalent and resource-constrained settings 2.3 Detecting latent TB infection in resource-constrained settings 2.3.1. Tuberculin skin test (TST) and IPT 2.3.2. Interferon-gamma release assays (IGRA) 2.4 Issues to consider for implementation of IPT 2.4.1 Primary ownership by HIV service providers 2.4.2 IPT and drug-resistant TB 2.4.3 Adherence and clinical follow up 2.4.4 Cost-effectiveness of IPT 3. Intensified tuberculosis case-finding and prevention in children living with HIV 3.1 Screening for TB 3.2 Regimen and duration 3.3 Secondary prophylaxis and IPT with ART in children 3.3.1 Secondary prophylaxis 3.3.2 IPT with ART in children 3.4 The role of TST and IGRA in evaluating children for IPT 3.5 Figure 2: Algorithm for TB screening in children more than one year of age and living with HIV 4. Research gaps 4.1 Screening for TB 4.2 Preventive treatment for TB 4.3 Operational research 5. References 6. Selected GRADE profiles 7 8 11 11 11 12 12 13 14 15 15 16 16 16 17 17 17 18 18 18 19 19 19 20 20 20 20 21 22 22 23 24 24 24 24 25 26 26 26 27 28 30 6
Abbreviations and acronyms AIDS ART ARV CDC CPT GRC GRADE HCV HIV ICF IGRA INH IPT LTBI MDR M&E PCR PEPFAR PMTCT TB The Union TST UNAIDS USAID WHO XDR acquired immunodeficiency syndrome antiretroviral therapy antiretroviral (drug) Centers for Disease Control and Prevention co-trimoxazole preventive therapy Guideline Review Committee Grading of Recommendations Assessment, Development and Evaluation hepatitis C virus human immunodeficiency virus intensified case-finding interferon-gamma release assay isonicotinic acid hydrazide/isoniazid isoniazid preventive therapy latent tuberculosis infection multidrug-resistant (TB, resistant to at least isoniazid and rifampicin) monitoring and evaluation polymerase chain reaction US President’s Emergency Plan for AIDS Relief prevention of mother-to-child transmission (of HIV) tuberculosis International Union Against Tuberculosis and Lung Disease tuberculin skin test The Joint United Nations Programme on HIV/AIDS United States Agency for International Development World Health Organization extensively drug-resistant TB (defined as resistance to at least rifampicin and isoniazid from among the first-line anti-TB drugs, in addition to resistance to any fluoroquinolone, and to at least one of three injectable second-line anti-TB drugs used in TB treatment [capreomycin, kanamicin and amikacin]) 7
Page 1 and 2: Guidelines for intensified tubercul
Page 3 and 4: WHO Library Cataloguing-in-Publicat
Page 5: Summary of declarations of interest
Page 9 and 10: Key recommendations 1 2 3 4 5 6 Adu
Page 11 and 12: 1. Background and process 1.1 Backg
Page 13 and 14: from the evidence are close to the
Page 15 and 16: 2. Intensified case-finding for and
Page 17 and 18: 2.2.2.1 Table 1: Comparison of the
Page 19 and 20: 2.3 Detecting latent TB infection i
Page 21 and 22: varied widely from 34% to 98%, and
Page 23 and 24: study showed that the absence of co
Page 25 and 26: Encouraging data show that IGRA are
Page 27 and 28: 4.3 Operational research • Potent
Page 29 and 30: Medicine, 1994, 9:695-721. 31. Mark
Page 31 and 32: GRADE profile table 2: TB screening
Page 33 and 34: No. of patients Summary of findings
Page 41 and 42: Continuous INH prophylaxis No. of p
Page 43 and 44: 6 months of INH prophylaxis No. of
Page 45 and 46: INH prophylaxis (6 months) No. of p
Page 47 and 48: Anti-TB medications No. of patients
Page 49 and 50: 29. Whalen CC et al. A trial of thr

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