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. 2018 Mar 20;18(1):136.
doi: 10.1186/s12879-018-3037-5.

HIV screening among newly diagnosed TB patients: a cross sectional study in Lima, Peru

Suzanne Ramírez  1 , Fernando Mejía  2   3 , Marlene Rojas  4 , Carlos Seas  1   2   3 , Patrick Van der Stuyft  5 , Eduardo Gotuzzo  1   2 , Larissa Otero  6   7
Affiliations

HIV screening among newly diagnosed TB patients: a cross sectional study in Lima, Peru

Suzanne Ramírez et al. BMC Infect Dis. .

Abstract

Background: Since 2006, the Peruvian National TB program (NTP) recommends voluntary counseling and testing (VCT) for all tuberculosis (TB) patients. Responding to the differential burden of both diseases in Peru, TB is managed in peripheral health facilities while HIV is managed in referral centers. This study aims to determine the coverage of HIV screening among TB patients and the characteristics of persons not screened.

Methods: From March 2010 to December 2011 we enrolled new smear-positive pulmonary TB adults in 34 health facilities in a district in Lima. NTP staff offered VCT to all TB patients. Patients with an HIV positive result were referred for confirmation tests and management. We interviewed patients to collect their demographic and clinical characteristics and registered if patients opted in or out of the screening.

Results: Of the 1295 enrolled TB patients, nine had a known HIV diagnosis. Of the remaining, 76.1% (979) were screened for HIV. Among the 23.9% (307) not screened, 38.4% (118) opted out of the screening. TB patients at one of the health care facilities of the higher areas of the district (OR = 3.38, CI 95% 2.17-5.28 for the highest area and OR = 2.82, CI 95% 1.78-4.49 for the high area) as well as those reporting illegal drug consumption (OR = 1.65, CI 95% 1.15-2.37) were more likely not to be screened. Twenty-four were HIV positive (1.9% of all patients 1295, or 2.4% of those screened). Of 15 patients diagnosed with HIV during the TB episode, ten were enrolled in an HIV program. The median time between the result of the HIV screening and the first consultation at the HIV program was 82 days (IQR, 32-414). The median time between the result of the HIV screening and antiretroviral initiation was 148.5 days (IQR 32-500).

Conclusions: An acceptable proportion of TB patients were screened for HIV in Lima. Referral systems of HIV positive patients should be strengthened for timely ART initiation.

Keywords: HIV; Peru; Tuberculosis; Voluntary counseling testing.

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Conflict of interest statement

Ethics approval and consent to participate

The protocol was approved by the Institutional Ethics Committees from the Universidad Peruana Cayetano Heredia. All participants signed an informed consent and received a copy of it. Participants that were screened for HIV by the study staff signed an additional informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Patients with a first episode of tuberculosis and HIV screening in San Juan de Lurigancho, 2010–2011
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