Screening for Latent Tuberculosis Infection in People Living with HIV: TUBHIVIT Project, a Multicenter Italian Study.

BACKGROUND: The coexistence of HIV infection and latent tuberculosis infection (LTBI) presents a significant public health concern due to the increased risk of tuberculosis (TB) reactivation and progression to active disease. The multicenter observational cohort study, TUBHIVIT, conducted in Italy from 2017 to 2023, aimed to assess the prevalence of LTBI among people living with HIV (PLHIV) and their outcomes following LTBI screening and therapy initiation. METHODS: We performed a prospective study in five referral centers for HIV care in Italy. PLHIV who consented Tto participate underwent QuantiFERON-TB Gold Plus and clinical, microbiological, and radiological assessments to exclude subclinical tuberculosis, as opportune. PLHIV diagnosed with LTBI who started chemoprophylaxis were followed until the end of therapy. RESULTS: A total of 1105 PLHIV were screened for LTBI using the QuantiFERON-TB Gold Plus test, revealing a prevalence of 3.4% of positive results (38/1105). Non-Italy-born individuals exhibited a significantly higher likelihood of testing positive. Thirty-one were diagnosed with LTBI, 1 showed active subclinical TB, and 6 were lost to follow-up before discriminating between latent and active TB. Among the PLHIV diagnosed with LTBI, 83.9% (26/31) started chemoprophylaxis. Most individuals received 6-9 months of isoniazid-based therapy. Of the 26 PLHIV commencing chemoprophylaxis, 18 (69.2%) completed the therapy, while 3 discontinued it and 5 were still on treatment at the time of the analysis. Adverse events were observed in two cases, while in one case the patient refused to continue the treatment.

Tuberculosis Infection Control: Experiences and Considerations from a Web Based Tool Implementation.

Tuberculosis (TB) remains a significant global health challenge. Indeed, according to the World Health Organization (WHO), TB is classified as the second most common cause of death worldwide due to a single infectious agent in 2022, following COVID-19. To effectively manage tuberculosis patients, it is necessary to ensure accurate diagnosis, prompt treatment initiation, and vigilant monitoring of patients' progress. In 2017, the TB Ge network was implemented and launched in two primary hospitals within the Liguria Region in Italy, with the main purpose to manage tuberculosis infections. This system, organized as a web-based tool, simplifies the manual input of patient's data and therapies, while automating the integration of test results from hospitals' Laboratory Information Systems (LIS), without requiring human intervention. The goal of this paper is to highlight the outcomes achieved through the implementation of the TB Ge network in a period seriously affected by the COVID-19 pandemia and outline future directions. More specifically, the aim is to extend its adoption to all hospitals in the Liguria Region, thus improving the management of tuberculosis infections across healthcare facilities.