Implementation of the cascade of care for latent mycobacterium tuberculosis infection in people living with HIV/Aids

Rev Gaucha Enferm. 2024 Dec 16;45(spe1):e20240116. doi: 10.1590/1983-1447.2024.20240116.en. eCollection 2024.
[Article in English, Portuguese]

Abstract

Objective: To describe the outcome indicators of implementing a cascade of care for latent Mycobacterium tuberculosis infection in people living with the human immunodeficiency virus.

Method: Cross-sectional study, carried out with people living with HIV, from 2022 to 2024, in a reference service in Campo Grande, Mato Grosso do Sul. It occurred after the implementation of the following work process: Identification of people at risk for investigation of Latent Tuberculosis Infection (LTBI); Test for LTBI; Exclusion of active TB cases; Treatment for LTBI; Adherence to treatment; and Completion of treatment. Data were analyzed using descriptive statistics, Chi-square test and Fisher's exact test.

Results: 735 people were monitored, of which 29.6% were indicated to start treatment for latent infection, and 32.5% started it. Treatment completion was higher in those who used the shortened regimen (90.2% versus 71.8%; p-value < 0.05, 7.8% with isoniazid and 2% with rifampin). There was one (0.9%) serious adverse reaction.

Conclusion: The implementation of the cascade of care demonstrated that 1⁄3 of participants had an indication for treatment and expanded access to recommended treatment. The conclusion was greater with the shortened scheme. Adverse reactions were infrequent.

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy
  • Acquired Immunodeficiency Syndrome / complications
  • Adult
  • Antitubercular Agents* / therapeutic use
  • Brazil
  • Cross-Sectional Studies
  • Female
  • HIV Infections* / complications
  • Humans
  • Isoniazid / therapeutic use
  • Latent Tuberculosis* / complications
  • Latent Tuberculosis* / drug therapy
  • Male
  • Medication Adherence
  • Middle Aged

Substances

  • Antitubercular Agents
  • Isoniazid