Practices and attitudes towards tuberculosis and latent tuberculosis infection screening in people living with HIV/AIDS among HIV physicians in Japan
Abstract Background Tuberculosis (TB) continues to be the leading cause of death for people living with HIV/AIDS (PLHIV), and HIV is the strongest known risk factor for progression to active TB disease for persons with latent TB infection (LTBI). Screening for active TB and LTBI, and TB preventive t...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | AIDS Research and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12981-022-00487-8 |
| _version_ | 1797985468382445568 |
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| author | Lisa Kawatsu Noriyo Kaneko Mayumi Imahashi Keisuke Kamada Kazuhiro Uchimura |
| author_facet | Lisa Kawatsu Noriyo Kaneko Mayumi Imahashi Keisuke Kamada Kazuhiro Uchimura |
| author_sort | Lisa Kawatsu |
| collection | DOAJ |
| description | Abstract Background Tuberculosis (TB) continues to be the leading cause of death for people living with HIV/AIDS (PLHIV), and HIV is the strongest known risk factor for progression to active TB disease for persons with latent TB infection (LTBI). Screening for active TB and LTBI, and TB preventive therapy (TPT) is recommended, however, clinical practices regarding LTBI screening for HIV positive population have not been uniform, resulting in low rates of LTBI screening and TPT uptake, in both low and high TB-burden countries. We sought to explore the practices and attitudes towards TB and LTBI screening in PLHIV among HIV physicians in Japan. Methods We conducted a cross-sectional survey whereby an on-line questionnaire was administered to physicians who are currently, or have the experience of, providing care and treatment for PLHIV in Japan. Results The questionnaire was sent to a total of 83 physicians, of which 59 responded (response rate; 71.1%). 52.5% (31/59) conducted routine screening and 44.0% (26/59) conducted selectively screening for active TB among HIV/AIDS patients. As for LTBI, 54.2% (32/59) conducted routine screening and 35.6% (21/59) conducted selective screening for LTBI among PLHIV. “T-SPOT only” was the most frequently used method of screening (n = 33), followed by “QFT only” (n = 11). Criteria for LTBI screening included TB burden in the country of birth of the patient, previous contact with a TB patient, and CD4+ cell count. 83.1% (49/59) either “always” or “selectively” offered TPT to PLHIV diagnosed with LTBI, and among the 49 respondents who did provide TPT, 77.6% (38/49) chose 9-months isoniazid as their first choice. None chose regimen including rifampicin. Conclusions Our study revealed that practices regarding TB and LTBI screening and treatment for PLHIV among HIV physicians were mixed and not necessarily in accordance with the various published guidelines. Building and disseminating scientific evidence that takes into consideration the local epidemiology of TB and HIV in Japan is urgently needed to assist physicians make decisions. |
| first_indexed | 2024-04-11T07:18:37Z |
| format | Article |
| id | doaj.art-49f4487dfde1465c8032c80986af34ee |
| institution | Directory Open Access Journal |
| issn | 1742-6405 |
| language | English |
| last_indexed | 2024-04-11T07:18:37Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | AIDS Research and Therapy |
| spelling | doaj.art-49f4487dfde1465c8032c80986af34ee2022-12-22T04:37:50ZengBMCAIDS Research and Therapy1742-64052022-12-0119111010.1186/s12981-022-00487-8Practices and attitudes towards tuberculosis and latent tuberculosis infection screening in people living with HIV/AIDS among HIV physicians in JapanLisa Kawatsu0Noriyo Kaneko1Mayumi Imahashi2Keisuke Kamada3Kazuhiro Uchimura4Department of Epidemiology and Clinical Research, The Research Institute of TuberculosisGraduate School of Nursing, Nagoya City UniversityLaboratory of Infectious Diseases, Department of Infectious Diseases and Immunology, National Hospital Organization Nagoya Medical CenterDepartment of Epidemiology and Clinical Research, The Research Institute of TuberculosisDepartment of Epidemiology and Clinical Research, The Research Institute of TuberculosisAbstract Background Tuberculosis (TB) continues to be the leading cause of death for people living with HIV/AIDS (PLHIV), and HIV is the strongest known risk factor for progression to active TB disease for persons with latent TB infection (LTBI). Screening for active TB and LTBI, and TB preventive therapy (TPT) is recommended, however, clinical practices regarding LTBI screening for HIV positive population have not been uniform, resulting in low rates of LTBI screening and TPT uptake, in both low and high TB-burden countries. We sought to explore the practices and attitudes towards TB and LTBI screening in PLHIV among HIV physicians in Japan. Methods We conducted a cross-sectional survey whereby an on-line questionnaire was administered to physicians who are currently, or have the experience of, providing care and treatment for PLHIV in Japan. Results The questionnaire was sent to a total of 83 physicians, of which 59 responded (response rate; 71.1%). 52.5% (31/59) conducted routine screening and 44.0% (26/59) conducted selectively screening for active TB among HIV/AIDS patients. As for LTBI, 54.2% (32/59) conducted routine screening and 35.6% (21/59) conducted selective screening for LTBI among PLHIV. “T-SPOT only” was the most frequently used method of screening (n = 33), followed by “QFT only” (n = 11). Criteria for LTBI screening included TB burden in the country of birth of the patient, previous contact with a TB patient, and CD4+ cell count. 83.1% (49/59) either “always” or “selectively” offered TPT to PLHIV diagnosed with LTBI, and among the 49 respondents who did provide TPT, 77.6% (38/49) chose 9-months isoniazid as their first choice. None chose regimen including rifampicin. Conclusions Our study revealed that practices regarding TB and LTBI screening and treatment for PLHIV among HIV physicians were mixed and not necessarily in accordance with the various published guidelines. Building and disseminating scientific evidence that takes into consideration the local epidemiology of TB and HIV in Japan is urgently needed to assist physicians make decisions.https://doi.org/10.1186/s12981-022-00487-8TuberculosisLatent tuberculosis infectionScreeningHIV/AIDSJapan |
| spellingShingle | Lisa Kawatsu Noriyo Kaneko Mayumi Imahashi Keisuke Kamada Kazuhiro Uchimura Practices and attitudes towards tuberculosis and latent tuberculosis infection screening in people living with HIV/AIDS among HIV physicians in Japan AIDS Research and Therapy Tuberculosis Latent tuberculosis infection Screening HIV/AIDS Japan |
| title | Practices and attitudes towards tuberculosis and latent tuberculosis infection screening in people living with HIV/AIDS among HIV physicians in Japan |
| title_full | Practices and attitudes towards tuberculosis and latent tuberculosis infection screening in people living with HIV/AIDS among HIV physicians in Japan |
| title_fullStr | Practices and attitudes towards tuberculosis and latent tuberculosis infection screening in people living with HIV/AIDS among HIV physicians in Japan |
| title_full_unstemmed | Practices and attitudes towards tuberculosis and latent tuberculosis infection screening in people living with HIV/AIDS among HIV physicians in Japan |
| title_short | Practices and attitudes towards tuberculosis and latent tuberculosis infection screening in people living with HIV/AIDS among HIV physicians in Japan |
| title_sort | practices and attitudes towards tuberculosis and latent tuberculosis infection screening in people living with hiv aids among hiv physicians in japan |
| topic | Tuberculosis Latent tuberculosis infection Screening HIV/AIDS Japan |
| url | https://doi.org/10.1186/s12981-022-00487-8 |
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