2018 Belgian guidelines for the screening for latent tuberculosis in HIV-infected patients

Acta Clin Belg. 2019 Aug;74(4):242-251. doi: 10.1080/17843286.2018.1494669. Epub 2018 Jul 23.

Abstract

Objectives: To review the current knowledge on screening for latent tuberculosis infection (LTBI) in HIV-infected adults and provide specific guidelines for Belgium. Focus is given to who to test, which testing method to use, timing of screening and choice of LTBI treatment. Methods: Expert review by the members of the Belgian LTBI group, in consultancy with the ARC College. Results: Target population, timing of screening, testing method, active TB exclusion, treatment of LTBI and guideline implementation are all reviewed. Conclusions: The principal changes include a selective approach to screen for LTBI (screening only of the HIV-infected patients at highest risk of active TB) as well as the timing of screening (testing for LTBI performed only after immune-restauration by antiretroviral therapy).

Keywords: HIV; Interferon-gamma release assay.; Latent tuberculosis; Screening; Tuberculin skin test.

Publication types

  • Practice Guideline

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active / methods
  • Belgium
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Incidence
  • Interferon-gamma Release Tests / methods
  • Latent Tuberculosis* / diagnosis
  • Latent Tuberculosis* / epidemiology
  • Latent Tuberculosis* / therapy
  • Male
  • Mass Screening* / methods
  • Mass Screening* / standards
  • Mycobacterium tuberculosis / isolation & purification*
  • Patient Care Management / methods
  • Patient Care Management / standards
  • Risk Assessment
  • Risk Factors
  • Tuberculin Test / methods