LF-LAM may be used to assist in the diagnosis of active TB in adult inpatients living with
HIV, with signs and symptoms of TB (pulmonary and/or extrapulmonary), who have a CD4
cell count less than or equal to 100 cells/mm3
or people living with HIV who are seriously
ill regardless of CD4 count or with unknown CD4 count.
Except as specifically described below for people with HIV infection with low CD4 counts or
who are seriously ill, urine lateral flow (LF)-LAM should not be used for the diagnosis of TB.
ART should be started in all TB patients living with HIV regardless of CD4 count.
Infants and children living with HIV who have poor weight gain, fever or current cough, or who
have a history of contact with a person with TB, should be evaluated for TB and other diseases
that cause such symptoms. If TB disease is excluded after an appropriate clinical evaluation or
according to national guidelines, these children should be offered TB preventive treatment,
regardless of their age.
Adults and adolescents living with HIV should be screened for TB according to a clinical
algorithm. Those who do not report any of the symptoms of current cough, fever, weight loss or
night sweats are unlikely to have active TB and should be offered preventive treatment, regardless
of their ART status.
All individuals with active TB should receive
(i) an assessment of their nutritional status
and (ii) appropriate counselling based on their
nutritional status at diagnosis and throughout
treatment.
Partners of known HIV-positive TB patients should be offered voluntary HIV testing and counselling
with mutual disclosure.
All health workers should be given appropriate information and encouraged to undergo TB diagnostic investigation if they
have signs and symptoms suggestive of TB (see rest of recommendation p. 12 of the guideline).
For patients with confirmed MDR/RR-TB, SL-LPA may be used as the initial test, instead of phenotypic culture-based DST, to detect resistance to the SLIDs.
For patients with confirmed MDR/RR-TB, SL-LPA may be used as the initial test, instead of phenotypic culture-based DST, to detect resistance to fluoroquinolones.