{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T02:24:23Z","timestamp":1764987863672,"version":"3.46.0"},"reference-count":49,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2012,1,23]]},"published-print":{"date-parts":[[2012]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HIV is the most important risk factor for progression of latent tuberculosis infection (LTBI) to active tuberculosis (TB). Detection and treatment of LTBI is necessary to reduce the increasing burden of TB in the UK, but a unified LTBI screening approach has not been adopted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effectiveness of a TB risk-focused approach to LTBI screening in the HIV-positive population against current UK National Institute for Health and Clinical Excellence (NICE) guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Two urban HIV treatment centres in London, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>114 HIV-infected individuals with defined TB risk factors were enrolled prospectively as part of ongoing studies into HIV and TB co-infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The yield and case detection rate of LTBI cases within the research study were compared with those generated by the NICE criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>17\/114 (14.9%, 95% CI 8.3 to 21.5) had evidence of LTBI. Limiting screening to those meeting NICE criteria for the general population (n=43) would have detected just over half of these, 9\/43 (20.9%, 95% CI 8.3 to 33.5) and those meeting criteria for HIV co-infection (n=74) would only have captured 8\/74(10.8%, 95% CI 3.6 to 18.1) cases. The case detection rates from the study and NICE approaches were not significantly different. LTBI was associated with the presence of multiple TB risk factors (p=0.002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adoption of a TB risk-focused screening algorithm that does not use CD4 count stratification could prevent more cases of TB reactivation, without changing the case detection rate. These findings should be used to inform a large-scale study to create unified guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2011-000762","type":"journal-article","created":{"date-parts":[[2012,3,3]],"date-time":"2012-03-03T15:34:28Z","timestamp":1330788868000},"page":"e000762","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of screening strategies to improve the diagnosis of latent tuberculosis infection in the HIV-positive population: a cohort study"],"prefix":"10.1136","volume":"2","author":[{"given":"Katrina M","family":"Pollock","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herman","family":"Tam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Grass","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharleen","family":"Bowes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham S","family":"Cooke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Pareek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damien","family":"Montamat-Sicotte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moses","family":"Kapembwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham P","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajit","family":"Lalvani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,3,1]]},"reference":[{"key":"2025120518053804000_2.2.e000762.1","unstructured":"HPA. Tuberculosis in the UK. Secondary Tuberculosis in the UK. 2011. http:\/\/www.hpa.org.uk\/webc\/HPAwebFile\/HPAweb_C\/1317131791612"},{"key":"2025120518053804000_2.2.e000762.2","unstructured":"ECDC\/WHO. Tuberculosis Surveillance in Europe Secondary Tuberculosis Surveillance in Europe. 2009. http:\/\/ecdc.europa.eu\/en\/publications\/Publications\/1103_TB_SUR_2009.pdf"},{"key":"2025120518053804000_2.2.e000762.3","doi-asserted-by":"crossref","unstructured":"Akolo C Adetifa I Shepperd S . Treatment of latent tuberculosis infection in HIV infected persons. Cochrane Database Syst Rev 2010;(1):CD000171.","DOI":"10.1002\/14651858.CD000171.pub3"},{"key":"2025120518053804000_2.2.e000762.4","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.01126-10"},{"key":"2025120518053804000_2.2.e000762.5","doi-asserted-by":"publisher","DOI":"10.1086\/498220"},{"key":"2025120518053804000_2.2.e000762.6","first-page":"1178","article-title":"Extra-pulmonary manifestations in a large metropolitan area with a low incidence of tuberculosis","volume":"7","author":"Gonzalez","year":"2003","journal-title":"Int J Tuberc Lung Dis"},{"key":"2025120518053804000_2.2.e000762.7","doi-asserted-by":"publisher","DOI":"10.1126\/science.1185449"},{"key":"2025120518053804000_2.2.e000762.8","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-10-7"},{"key":"2025120518053804000_2.2.e000762.9","unstructured":"NICE . NICE Clinical Guideline 117. Tuberculosis. Clinical Diagnosis and Management of Tuberculosis, and Measures for Its Prevention and Control. 2011. http:\/\/www.nice.org.uk\/nicemedia\/live\/13422\/53642\/53642.pdf"},{"key":"2025120518053804000_2.2.e000762.10","doi-asserted-by":"publisher","DOI":"10.1086\/651493"},{"key":"2025120518053804000_2.2.e000762.11","unstructured":"WHO. TB\/HIV Facts Secondary TB\/HIV Facts. 2011. http:\/\/www.who.int\/tb\/challenges\/hiv\/factsheet_hivtb_2011.pdf"},{"key":"2025120518053804000_2.2.e000762.12","doi-asserted-by":"publisher","DOI":"10.1086\/426827"},{"key":"2025120518053804000_2.2.e000762.13","doi-asserted-by":"publisher","DOI":"10.1126\/science.1086845"},{"key":"2025120518053804000_2.2.e000762.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06712-5"},{"key":"2025120518053804000_2.2.e000762.15","doi-asserted-by":"publisher","DOI":"10.1086\/506432"},{"key":"2025120518053804000_2.2.e000762.16","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00115110"},{"key":"2025120518053804000_2.2.e000762.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60204-3"},{"key":"2025120518053804000_2.2.e000762.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2011.00954.x"},{"key":"2025120518053804000_2.2.e000762.19","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200211220-00008"},{"key":"2025120518053804000_2.2.e000762.20","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.124891"},{"key":"2025120518053804000_2.2.e000762.21","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq017"},{"key":"2025120518053804000_2.2.e000762.22","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2008.077560"},{"key":"2025120518053804000_2.2.e000762.23","doi-asserted-by":"publisher","DOI":"10.1086\/367664"},{"key":"2025120518053804000_2.2.e000762.24","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-7-56"},{"key":"2025120518053804000_2.2.e000762.25","first-page":"1190","article-title":"Utility of QuantiFERON-TB Gold in-tube testing for latent TB infection in HIV-infected individuals","volume":"11","author":"Jones","year":"2007","journal-title":"Int J Tuberc Lung Dis"},{"key":"2025120518053804000_2.2.e000762.26","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp308"},{"key":"2025120518053804000_2.2.e000762.27","first-page":"980","article-title":"Smoking and tuberculosis in Hong Kong","volume":"7","author":"Leung","year":"2003","journal-title":"Int J Tuberc Lung Dis"},{"key":"2025120518053804000_2.2.e000762.28","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200404-512OC"},{"key":"2025120518053804000_2.2.e000762.29","first-page":"430","article-title":"Clinical and epidemiological aspects of smoking and tuberculosis: a study of 13,038 cases","volume":"9","author":"Altet-Gomez","year":"2005","journal-title":"Int J Tuberc Lung Dis"},{"key":"2025120518053804000_2.2.e000762.30","doi-asserted-by":"crossref","first-page":"65","DOI":"10.2105\/AJPH.76.1.65","article-title":"The cumulative risk of tuberculin skin test conversion for five years of hospital employment","volume":"76","author":"Ktsanes","year":"1986","journal-title":"Am J Public Health"},{"key":"2025120518053804000_2.2.e000762.31","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2006.028068"},{"key":"2025120518053804000_2.2.e000762.32","doi-asserted-by":"publisher","DOI":"10.3201\/eid1703.100947"},{"key":"2025120518053804000_2.2.e000762.33","first-page":"1183","article-title":"Tuberculosis infection in drug users: interferon-gamma release assay performance","volume":"11","author":"Grimes","year":"2007","journal-title":"Int J Tuberc Lung Dis"},{"key":"2025120518053804000_2.2.e000762.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2010.12.002"},{"key":"2025120518053804000_2.2.e000762.35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000381"},{"key":"2025120518053804000_2.2.e000762.36","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-5-200803040-00003"},{"key":"2025120518053804000_2.2.e000762.37","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70069-X"},{"key":"2025120518053804000_2.2.e000762.38","unstructured":"HPA. Diagnosed HIV-Infected Individuals Seen for Care. Survey of Prevalent HIV Infections Diagnosed (SOPHID). Black-African and Black-Caribbean Data Tables. 2011. http:\/\/www.hpa.org.uk\/web\/HPAwebFile\/HPAweb_C\/1221482345789"},{"key":"2025120518053804000_2.2.e000762.39","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198903023200901"},{"key":"2025120518053804000_2.2.e000762.40","doi-asserted-by":"publisher","DOI":"10.1086\/597351"},{"key":"2025120518053804000_2.2.e000762.41","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1186\/1471-2334-10-348","article-title":"IFN-gamma response on T-cell based assays in HIV-infected patients for detection of tuberculosis infection","volume":"10","author":"Latorre","year":"2010","journal-title":"BMC Infect Dis"},{"key":"2025120518053804000_2.2.e000762.42","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283188415"},{"key":"2025120518053804000_2.2.e000762.43","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283320dfd"},{"key":"2025120518053804000_2.2.e000762.44","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0001441"},{"key":"2025120518053804000_2.2.e000762.45","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17592-2"},{"key":"2025120518053804000_2.2.e000762.46","first-page":"417","article-title":"High level of discordant IGRA results in HIV-infected adults and children","volume":"12","author":"Mandalakas","year":"2008","journal-title":"Int J Tuberc Lung Dis"},{"key":"2025120518053804000_2.2.e000762.47","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31820b07ab"},{"key":"2025120518053804000_2.2.e000762.48","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00045509"},{"key":"2025120518053804000_2.2.e000762.49","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2249.2007.03477.x"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2011-000762","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T02:05:45Z","timestamp":1764986745000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2011-000762"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":49,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2012,3,1]]},"published-print":{"date-parts":[[2012]]}},"alternative-id":["10.1136\/bmjopen-2011-000762"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2011-000762","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2012]]}}}