HIV testing uptake among the household contacts of multidrugresistant tuberculosis index cases in eight countries

V. S. Opollo, X. Wu, M. D. Hughes, Susan Swindells, A. Gupta, A. Hesseling, G. Churchyard, S. Kim, R. Lando, R. Dawson, V. Mave, A. Mendoza, P. Gonzales, N. Kumarasamy, F. Von Groote-Bidlingmaier, F. Conradie, J. Shenje, S. N. Fontain, A. Garcia-Prats, A. AsmelashS. Nedsuwan, L. Mohapi, R. Mngqibisa, A. C.Garcia Ferreira, E. Okeyo, L. Naini, L. Jones, B. Smith, N. S. Shah

Research output: Contribution to journalArticle

Abstract

SETTING: The household contacts (HHCs) of multidrug-resistant tuberculosis (MDR-TB) index cases are at high risk of tuberculous infection and disease progression, particularly if infected with the human immunodeficiency virus (HIV). HIV testing is important for risk assessment and clinical management. METHODS: This was a cross-sectional, multi-country study of adult MDR-TB index cases and HHCs. All adult and child HHCs were offered HIV testing if never tested or if HIV-negative >1 year previously when last tested. We measured HIV testing uptake and used logistic regression to evaluate predictors. RESULTS: A total of 1007 HHCs of 284 index cases were enrolled in eight countries. HIV status was known at enrolment for 226 (22%) HHCs; 39 (4%) were HIVpositive. HIV testing was offered to 769 (98%) of the 781 remaining HHCs; 544 (71%) agreed to testing. Of 535 who were actually tested, 26 (5%) were HIVinfected. HIV testing uptake varied by site (median 86%, range 0-100%; P < 0.0001), and was lower in children aged <18 years than in adults (59% vs. 78%; adjusted for site P < 0.0001). CONCLUSIONS: HIV testing of HHCs of MDR-TB index cases is feasible and high-yield, with 5% testing positive. Reasons for low test uptake among children and at specific sites-including sites with high HIV prevalence-require further study to ensure all persons at risk for HIV are aware of their status.

Original languageEnglish (US)
Pages (from-to)1443-1449
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume22
Issue number12
DOIs
StatePublished - Dec 1 2018

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Tuberculosis
HIV
Multidrug-Resistant Tuberculosis
Disease Progression
Logistic Models
Infection

Keywords

  • Barriers
  • HCT testing
  • Willingness to test

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

HIV testing uptake among the household contacts of multidrugresistant tuberculosis index cases in eight countries. / Opollo, V. S.; Wu, X.; Hughes, M. D.; Swindells, Susan; Gupta, A.; Hesseling, A.; Churchyard, G.; Kim, S.; Lando, R.; Dawson, R.; Mave, V.; Mendoza, A.; Gonzales, P.; Kumarasamy, N.; Von Groote-Bidlingmaier, F.; Conradie, F.; Shenje, J.; Fontain, S. N.; Garcia-Prats, A.; Asmelash, A.; Nedsuwan, S.; Mohapi, L.; Mngqibisa, R.; Ferreira, A. C.Garcia; Okeyo, E.; Naini, L.; Jones, L.; Smith, B.; Shah, N. S.

In: International Journal of Tuberculosis and Lung Disease, Vol. 22, No. 12, 01.12.2018, p. 1443-1449.

Research output: Contribution to journalArticle

Opollo, VS, Wu, X, Hughes, MD, Swindells, S, Gupta, A, Hesseling, A, Churchyard, G, Kim, S, Lando, R, Dawson, R, Mave, V, Mendoza, A, Gonzales, P, Kumarasamy, N, Von Groote-Bidlingmaier, F, Conradie, F, Shenje, J, Fontain, SN, Garcia-Prats, A, Asmelash, A, Nedsuwan, S, Mohapi, L, Mngqibisa, R, Ferreira, ACG, Okeyo, E, Naini, L, Jones, L, Smith, B & Shah, NS 2018, 'HIV testing uptake among the household contacts of multidrugresistant tuberculosis index cases in eight countries', International Journal of Tuberculosis and Lung Disease, vol. 22, no. 12, pp. 1443-1449. https://doi.org/10.5588/ijtld.18.0108
Opollo, V. S. ; Wu, X. ; Hughes, M. D. ; Swindells, Susan ; Gupta, A. ; Hesseling, A. ; Churchyard, G. ; Kim, S. ; Lando, R. ; Dawson, R. ; Mave, V. ; Mendoza, A. ; Gonzales, P. ; Kumarasamy, N. ; Von Groote-Bidlingmaier, F. ; Conradie, F. ; Shenje, J. ; Fontain, S. N. ; Garcia-Prats, A. ; Asmelash, A. ; Nedsuwan, S. ; Mohapi, L. ; Mngqibisa, R. ; Ferreira, A. C.Garcia ; Okeyo, E. ; Naini, L. ; Jones, L. ; Smith, B. ; Shah, N. S. / HIV testing uptake among the household contacts of multidrugresistant tuberculosis index cases in eight countries. In: International Journal of Tuberculosis and Lung Disease. 2018 ; Vol. 22, No. 12. pp. 1443-1449.
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T1 - HIV testing uptake among the household contacts of multidrugresistant tuberculosis index cases in eight countries

AU - Opollo, V. S.

AU - Wu, X.

AU - Hughes, M. D.

AU - Swindells, Susan

AU - Gupta, A.

AU - Hesseling, A.

AU - Churchyard, G.

AU - Kim, S.

AU - Lando, R.

AU - Dawson, R.

AU - Mave, V.

AU - Mendoza, A.

AU - Gonzales, P.

AU - Kumarasamy, N.

AU - Von Groote-Bidlingmaier, F.

AU - Conradie, F.

AU - Shenje, J.

AU - Fontain, S. N.

AU - Garcia-Prats, A.

AU - Asmelash, A.

AU - Nedsuwan, S.

AU - Mohapi, L.

AU - Mngqibisa, R.

AU - Ferreira, A. C.Garcia

AU - Okeyo, E.

AU - Naini, L.

AU - Jones, L.

AU - Smith, B.

AU - Shah, N. S.

PY - 2018/12/1

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N2 - SETTING: The household contacts (HHCs) of multidrug-resistant tuberculosis (MDR-TB) index cases are at high risk of tuberculous infection and disease progression, particularly if infected with the human immunodeficiency virus (HIV). HIV testing is important for risk assessment and clinical management. METHODS: This was a cross-sectional, multi-country study of adult MDR-TB index cases and HHCs. All adult and child HHCs were offered HIV testing if never tested or if HIV-negative >1 year previously when last tested. We measured HIV testing uptake and used logistic regression to evaluate predictors. RESULTS: A total of 1007 HHCs of 284 index cases were enrolled in eight countries. HIV status was known at enrolment for 226 (22%) HHCs; 39 (4%) were HIVpositive. HIV testing was offered to 769 (98%) of the 781 remaining HHCs; 544 (71%) agreed to testing. Of 535 who were actually tested, 26 (5%) were HIVinfected. HIV testing uptake varied by site (median 86%, range 0-100%; P < 0.0001), and was lower in children aged <18 years than in adults (59% vs. 78%; adjusted for site P < 0.0001). CONCLUSIONS: HIV testing of HHCs of MDR-TB index cases is feasible and high-yield, with 5% testing positive. Reasons for low test uptake among children and at specific sites-including sites with high HIV prevalence-require further study to ensure all persons at risk for HIV are aware of their status.

AB - SETTING: The household contacts (HHCs) of multidrug-resistant tuberculosis (MDR-TB) index cases are at high risk of tuberculous infection and disease progression, particularly if infected with the human immunodeficiency virus (HIV). HIV testing is important for risk assessment and clinical management. METHODS: This was a cross-sectional, multi-country study of adult MDR-TB index cases and HHCs. All adult and child HHCs were offered HIV testing if never tested or if HIV-negative >1 year previously when last tested. We measured HIV testing uptake and used logistic regression to evaluate predictors. RESULTS: A total of 1007 HHCs of 284 index cases were enrolled in eight countries. HIV status was known at enrolment for 226 (22%) HHCs; 39 (4%) were HIVpositive. HIV testing was offered to 769 (98%) of the 781 remaining HHCs; 544 (71%) agreed to testing. Of 535 who were actually tested, 26 (5%) were HIVinfected. HIV testing uptake varied by site (median 86%, range 0-100%; P < 0.0001), and was lower in children aged <18 years than in adults (59% vs. 78%; adjusted for site P < 0.0001). CONCLUSIONS: HIV testing of HHCs of MDR-TB index cases is feasible and high-yield, with 5% testing positive. Reasons for low test uptake among children and at specific sites-including sites with high HIV prevalence-require further study to ensure all persons at risk for HIV are aware of their status.

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