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Tuberculosis screening among HIV-infected patients: tuberculin skin test vs. interferon-gamma release assay.

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Title: Tuberculosis screening among HIV-infected patients: tuberculin skin test vs. interferon-gamma release assay.
Authors: Adams, J. W. (AUTHOR), Howe, C. J. (AUTHOR), Andrews, A. C. (AUTHOR), Allen, S. L. (AUTHOR), Vinnard, C. (AUTHOR)
Source: AIDS Care. Dec2017, Vol. 29 Issue 12, p1504-1509. 6p.
Subjects: Diagnosis of HIV infections, Tuberculosis diagnosis, Medical screening evaluation, Medical protocols, Poisson distribution, Regression analysis, Tuberculin test, Retrospective studies, Interferon gamma release tests
Abstract: National guidelines recommend screening for latent tuberculosis infection (LTBI) in all HIV-infected patients. Thus, the objective of this study was to measure protocol adherence to national guidelines regarding LTBI screening for HIV-infected patients entering care at an urban primary care clinic specializing in HIV care, identify clinical and other characteristics associated with adherence, and determine whether transitioning from the tuberculin skin test (TST) to the interferon-gamma release assay (IGRA) improved adherence. We conducted a retrospective study using protocol adherence to LTBI screening guidelines within twelve months of entering care at an HIV clinic as the primary outcome. Successful protocol adherence was defined as the placement and reading of a TST, performance of an IGRA, or a note in study clinic records documenting prior testing or treatment for tuberculosis in an outside setting. Multivariable modified Poisson regression models were used in analyses. Overall, 32% (n = 118/372) of patients received LTBI screening within twelve months of entering care. Protocol adherence to LTBI screening guidelines increased from 28% to 37% following the transition from TST to IGRA screening. IGRA screening [adjusted prevalence ratio: 1.45, 95% confidence limits: (1.07, 1.96)], male sex [1.47 (1.05, 2.07)], transfer patient status [1.51 (1.05, 2.18)], and greater than one year of clinic attendance [1.62 (1.06, 2.48)] were independently associated with protocol adherence. Among patients without prior LTBI screening or treatment, patients entering the clinic in 2013 under the IGRA screening protocol were more likely to be screened for LTBI compared to patients entering under the TST screening protocol (34.3% vs. 9.7%,p < 0.001). In conclusion, transitioning from TST to IGRA-based screening improved adherence to screening guidelines. However, further work on improving adherence to LTBI screening guidelines among HIV-infected patients is needed. [ABSTRACT FROM AUTHOR]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Tuberculosis screening among HIV-infected patients: tuberculin skin test vs. interferon-gamma release assay.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Adams%2C+J%2E+W%2E%22&quot;&gt;Adams, J. W.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Howe%2C+C%2E+J%2E%22&quot;&gt;Howe, C. J.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Andrews%2C+A%2E+C%2E%22&quot;&gt;Andrews, A. C.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Allen%2C+S%2E+L%2E%22&quot;&gt;Allen, S. L.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Vinnard%2C+C%2E%22&quot;&gt;Vinnard, C.&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22AIDS+Care%22&quot;&gt;AIDS Care&lt;/searchLink&gt;. Dec2017, Vol. 29 Issue 12, p1504-1509. 6p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Diagnosis+of+HIV+infections%22&quot;&gt;Diagnosis of HIV infections&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Tuberculosis+diagnosis%22&quot;&gt;Tuberculosis diagnosis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+screening+evaluation%22&quot;&gt;Medical screening evaluation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+protocols%22&quot;&gt;Medical protocols&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Poisson+distribution%22&quot;&gt;Poisson distribution&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Regression+analysis%22&quot;&gt;Regression analysis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Tuberculin+test%22&quot;&gt;Tuberculin test&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Retrospective+studies%22&quot;&gt;Retrospective studies&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Interferon+gamma+release+tests%22&quot;&gt;Interferon gamma release tests&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: National guidelines recommend screening for latent tuberculosis infection (LTBI) in all HIV-infected patients. Thus, the objective of this study was to measure protocol adherence to national guidelines regarding LTBI screening for HIV-infected patients entering care at an urban primary care clinic specializing in HIV care, identify clinical and other characteristics associated with adherence, and determine whether transitioning from the tuberculin skin test (TST) to the interferon-gamma release assay (IGRA) improved adherence. We conducted a retrospective study using protocol adherence to LTBI screening guidelines within twelve months of entering care at an HIV clinic as the primary outcome. Successful protocol adherence was defined as the placement and reading of a TST, performance of an IGRA, or a note in study clinic records documenting prior testing or treatment for tuberculosis in an outside setting. Multivariable modified Poisson regression models were used in analyses. Overall, 32% (n = 118/372) of patients received LTBI screening within twelve months of entering care. Protocol adherence to LTBI screening guidelines increased from 28% to 37% following the transition from TST to IGRA screening. IGRA screening [adjusted prevalence ratio: 1.45, 95% confidence limits: (1.07, 1.96)], male sex [1.47 (1.05, 2.07)], transfer patient status [1.51 (1.05, 2.18)], and greater than one year of clinic attendance [1.62 (1.06, 2.48)] were independently associated with protocol adherence. Among patients without prior LTBI screening or treatment, patients entering the clinic in 2013 under the IGRA screening protocol were more likely to be screened for LTBI compared to patients entering under the TST screening protocol (34.3% vs. 9.7%,p &lt; 0.001). In conclusion, transitioning from TST to IGRA-based screening improved adherence to screening guidelines. However, further work on improving adherence to LTBI screening guidelines among HIV-infected patients is needed. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of AIDS Care is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=125602780
RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1080/09540121.2017.1325438
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      – Code: eng
        Text: English
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        PageCount: 6
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    Subjects:
      – SubjectFull: Diagnosis of HIV infections
        Type: general
      – SubjectFull: Tuberculosis diagnosis
        Type: general
      – SubjectFull: Medical screening evaluation
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      – SubjectFull: Medical protocols
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      – SubjectFull: Poisson distribution
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      – SubjectFull: Regression analysis
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      – SubjectFull: Tuberculin test
        Type: general
      – SubjectFull: Retrospective studies
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      – SubjectFull: Interferon gamma release tests
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      – TitleFull: Tuberculosis screening among HIV-infected patients: tuberculin skin test vs. interferon-gamma release assay.
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              Text: Dec2017
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