P220 Chemoprophylaxis for latent tuberculosis in the UK: changing trends across three cohorts over 13 years

<h3>Introduction</h3> UK national guidance for screening for tuberculosis (TB) has changed over the years. This study retrospectively evaluated the shifts across three cohorts of latent TB cases managed over a thirteen-year period in our hospital. <h3>Methods</h3> Patients diagnosed with latent TB between January 2019-December 2021 (Cohort-3) were evaluated and compared to previous studies of Cohort-1 (September 2008-October 2011) and Cohort-2 (November 2011-October 2014). Patient demographics, screening rationale, chemoprophylaxis acceptance and completion rates, and side effect profiles were compared. <h3>Results</h3> This study included 363 latent TB patients, with increasing cohort size of 59, 113, and 191 respectively. Over half of Cohort-1 and 3 were aged 35 and under. Cohort-1 and 2 predominately comprised patients from sub-Saharan Africa (62% and 54%), while Cohort-3 had a majority of ‘White-British’ patients (31%) with only 14% from sub-Saharan Africa. Referral sources varied;Cohort-1 included contact screening (41%) and occupational health (32%); Cohort-2 mainly occupational health (63%) and contact screening (21%); in Cohort-3, most referrals were from other specialties (46%). Chemoprophylaxis acceptance was highest in Cohort-2 (92%), followed by Cohort-1 (79%) and Cohort-3 (78%). Completion rates were 91% for Cohort-1, 93.4% for Cohort-2, and 96% for Cohort-3. Chemoprophylaxis uptake varied among healthcare workers across cohorts, and side effects were variable across the three cohorts. <h3>Conclusion</h3> Demographic shifts reflect changes in TB screening guidance, with increasing referrals from specialties requiring immunosuppressive therapy.Interestingly, acceptance rates closely mirrored healthcare worker uptake in Cohort-1 &amp; 2. Most referrals from other specialties had limited treatment choice, possibly contributing to higher uptake in Cohort-3.