O02 Screening for latent tuberculosis in a large urban HIV positive population – pilot reveals 11.6% positivity rate

<h3>Introduction</h3> National tuberculosis (TB) HIV guidelines published in 2018¹ recommend latent TB testing with interferon gamma-release assay (IGRA) in at-risk populations. <h3>Methods</h3> The HIV department liaised with the TB department to develop a referral protocol for positive IGRA. One consultant piloted the programme using opportunistic IGRA at the patients‘ routine blood appointments commencing in summer 2020. <h3>Results</h3> Of 181 patients, 18 were not eligible for IGRA due to previous TB or being low risk. Of 103 patients tested, 91 had a negative IGRA, with twelve testing positive; eleven female and one male. Two patients were of Asian ethnicity, with ten of Black African ethnicity. Positive patients had a mean age of 53 (range 23-75), and mean CD4 of 692 (range 282-1090). All were on HIV treatment with an undetectable viral load. Ten patients had a normal chest x-ray, one required CT with no evidence of TB, and one remains pending. Of the eight patients seen by the TB team so far, five have been started on treatment, four on isoniazid for six months, one on Rifinah for three months. One is pending. Two have declined treatment due to concern over side effects. <h3>Discussion</h3> A latent TB positivity rate of 11.6% extrapolates to &gt;100 patients across our departmental cohort. Testing has been limited by the opportunistic nature of tests and that the assay must be received by the laboratory in the morning. A bimonthly HIV/TB multi-disciplinary team meeting has also been set up to discuss complex cases of both active and latent TB. <h3>Reference</h3> British HIV Association, 2021, BHIVA guidelines for the management of tuberculosis in adults living with HIV 2018 (2021 interim update) Accessed 24/04/2022 https://www.bhiva.org/TB-guidelines