BibTex format
@article{Degtyareva:2025:10.1183/13993003.02174-2023,
author = {Degtyareva, S and Hamada, Y and Baggaley, RF and Hassan, N and Capocci, S and van, Crevel R and van, Geuns D and Miller, R and Pareek, M and Pozniak, A and Rangaka, MX and Tiberi, S and de, Vries G and Lipman, M and Brown, J},
doi = {10.1183/13993003.02174-2023},
journal = {European Respiratory Journal},
pages = {2302174--2302174},
title = {Tuberculosis Preventive Treatment care pathways in people living with HIV: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1183/13993003.02174-2023},
year = {2025}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - <jats:sec><jats:title>Background</jats:title><jats:p>Tuberculosis Preventive Treatment (TPT) can reduce TB incidence and mortality in people living with HIV. However, low levels of screening and uptake, poor adherence, and loss to follow-up considerably reduce its effectiveness. We aimed, therefore, to assess the losses within all steps of the screening and treatment cascade.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>To enhance data generalizibility we included articles which reported the proportion of people living with HIV completing any step of the TPT cascade in low- and high-TB burden countries published before March 2024. Random effects meta-analysis produced pooled estimates of the proportion proceeding to the next step along the cascade. Results were explored through subgroup analyses and meta-regression. PROSPERO registration: CRD42020162396.</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>Data from 368 cohorts containing 2.7 million participants were included. High levels of heterogeneity in outcomes were seen. Most participants were from Africa (80.6%). Isoniazid monotherapy was used for TPT in 92.6% of cohorts, usually for six months. Substantial loss to follow-up was found throughout the treatment cascade with more than one in six patients lost at the following steps: initial screening, immunological testing, treatment start and completion. Treatment regimens lasting four months or less were more likely to be completed than longer ones – 88.4% compared to 61.6%.</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p>Our analysis highlights substantial loss to follow-up at multiple steps during the care cascade. This may significantly lower the reported effectiveness of TPT in real-world settings. Research and policy should focus on simplified care p
AU - Degtyareva,S
AU - Hamada,Y
AU - Baggaley,RF
AU - Hassan,N
AU - Capocci,S
AU - van,Crevel R
AU - van,Geuns D
AU - Miller,R
AU - Pareek,M
AU - Pozniak,A
AU - Rangaka,MX
AU - Tiberi,S
AU - de,Vries G
AU - Lipman,M
AU - Brown,J
DO - 10.1183/13993003.02174-2023
EP - 2302174
PY - 2025///
SN - 0903-1936
SP - 2302174
TI - Tuberculosis Preventive Treatment care pathways in people living with HIV: a systematic review and meta-analysis
T2 - European Respiratory Journal
UR - http://dx.doi.org/10.1183/13993003.02174-2023
UR - https://doi.org/10.1183/13993003.02174-2023
ER -