Bibliographic Info
Recommendation
Recommended in favor
Conditional
Certainty of evidence
Low
In resource-constrained settings with high TB incidence and transmission, adults and adolescents living with HIV, who have an unknown or positive tuberculin skin test (TST) status and among whom active TB disease has been safely ruled out, should receive at least 36 months of isoniazid preventive therapy (IPT). IPT should be given to such individuals regardless of whether or not they are receiving ART. IPT should also be given irrespective of the degree of immunosuppression, history of previous TB treatment, and pregnancy
Notes and Remarks
People living with HIV in high TB incidence and transmission settings, regardless of their TST status, benefit more from IPT of 36 months or longer, compared to six-month IPT, with greater protective benefit in those with a positive TST. There is a significant additional benefit from longer-term IPT for those receiving ART. TST is encouraged whenever feasible, but it is not a pre-requisite for IPT. If TST is performed, those with a negative TST should not receive 36 months of IPT. Settings with high TB incidence and transmission should be defined by national authorities, taking into consideration the local epidemiology and transmission of both TB and HIV.
Also Featured In
This recommendation also appears in the following guidelines:
WHO policy on collaborative TB/HIV activities : guidelines for national programmes and other stakeholders
Guidelines for intensified tuberculosis case-finding and isoniazid preventive therapy for people living with HIV in resource-constrained settings
Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach
Latent tuberculosis infection: updated and consolidated guidelines for programmatic management
WHO consolidated guidelines on tuberculosis: tuberculosis preventive treatment: Module 1: prevention
Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach
WHO consolidated guidelines on tuberculosis: module 5: management of tuberculosis in children and adolescents.
WHO consolidated guidelines on tuberculosis: module 6: tuberculosis and comorbidities.
WHO consolidated guidelines on tuberculosis: module 6: tuberculosis and comorbidities, 2nd ed.