Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/153868
Title: Lack of latent tuberculosis (TB) screening and delay in anti-retroviral therapy initiation in HIV-TB co-infection: an 11-year study in an intermediate TB-burden country
Authors: Teng, Vannesa Yue May
Chua, Yan Ting
Lai, Eunice En Ni
Mukherjee, Shilpa
Michaels, Jessica
Wong, Chen Seong
Shen, Liang
Leo, Yee Sin
Young, Barnaby Edward
Archuleta, Sophia
Ong, Catherine W. M.
Keywords: Science::Medicine
Issue Date: 2021
Source: Teng, V. Y. M., Chua, Y. T., Lai, E. E. N., Mukherjee, S., Michaels, J., Wong, C. S., Shen, L., Leo, Y. S., Young, B. E., Archuleta, S. & Ong, C. W. M. (2021). Lack of latent tuberculosis (TB) screening and delay in anti-retroviral therapy initiation in HIV-TB co-infection: an 11-year study in an intermediate TB-burden country. International Journal of Infectious Diseases, 113, 178-183. https://dx.doi.org/10.1016/j.ijid.2021.09.048
Project: NMRC/TA/0042/2015 
CSAINV17nov014 
NUHS/RO/2017/092/SU/01 
Journal: International Journal of Infectious Diseases 
Abstract: Objectives: To examine the prevalence and characteristics of HIV-tuberculosis (TB) co-infected patients in Singapore, an intermediate TB-burden country. Methods: Retrospective data across 11 years was obtained from the National University Hospital (NUH), a quaternary hospital and the National Centre for Infectious Diseases (NCID), the national HIV center. Results: From December 2005 to December 2016, 4015 HIV-infected patients were managed at NUH and NCID, of whom, respectively, 48 and 272 were diagnosed with active TB disease. Only 2 patients (0.6%) were screened for latent TB infection on HIV diagnosis. Mean CD4 count at TB diagnosis was 125.0 +/- 153.9 cells/mm(3). More patients with HIV diagnosed >= 6 weeks before TB (41%) were associated with CD4 counts > 200 cells/mm(3) than patients with TB diagnosed > 6 weeks before HIV (2%). Of 124 (38.6%) HIV-TB patients with CD4 count <= 50 cells/mm3, only 18 (14.2%) started anti-retroviral therapy (ART) in < 2 weeks. Of patients with pulmonary TB, 33.5% had normal chest x-ray. Conclusions: Latent TB infection screening in HIV-infected patients is low, and ART initiation is delayed in HIV-TB patients with CD4 <= 50 cells/mm(3). Pulmonary TB patients with HIV can be infectious despite normal chest x-ray. Clinical practices can be further improved to benefit HIV-TB patients. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
URI: https://hdl.handle.net/10356/153868
ISSN: 1201-9712
DOI: 10.1016/j.ijid.2021.09.048
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: National Centre for Infectious Disease
Tan Tock Seng Hospital
Rights: © 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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