in_the_evidence

Systematic screening for active TB should be considered
in people with an untreated fibrotic chest X-ray lesion.

Systematic screening for active TB should be considered
in prisons and other penitentiary institutions.

Current and former workers in workplaces with silica
exposure should be systematically screened for active TB.

People living with HIV should be systematically screened
for active TB at each visit to a health facility.

Household contacts and other close contacts should be
systematically screened for active TB.

The Expert Group recommended that the Genotype MTBDRsl assay cannot be used as a replacement
test for conventional phenotypic DST.

Children living with HIV who do not have poor weight gain, fever or current cough are unlikely to
have active TB.

Providing IPT to people living with HIV does not increase the risk of developing isoniazid-resistant
TB. Therefore, concerns regarding the development of INH resistance should not be a barrier to
providing IPT.

Tuberculin skin test (TST) is not a requirement for initiating IPT in people living with HIV (strong
recommendation, moderate quality of evidence). People living with HIV who have a positive
TST benefit more from IPT; TST can be used where feasible to identify such individuals.

Adults and adolescents living with HIV who have an unknown or positive TST status and who are
unlikely to have active TB should receive at least 36 months of IPT. IPT should be given to such
individuals irrespective of the degree of immunosuppression, and also those on ART, those who
have previously been treated for TB and pregnant women.