The recommendations state that patients should be offered screeni

The recommendations state that patients should be offered screening with IGRA if (and only if) they are in one of these groups and would benefit from chemoprophylaxis [BII]. Therefore, the recommendation is to consider screening in HIV-positive patients from: sub-Saharan Africa, if the length of current ART is under 2 years, whatever the current blood CD4 cell count; medium TB incidence3 countries, if the length of current ART is under 2 years and current CD4 count is less than 500 cells/μL; low-incidence countries,

e.g. Caucasians from the UK, if not on ART, or if the length of current ART is less than 6 months and current CD4 count is less than 350 cells/μL. Routine induced sputum analysis in asymptomatic patients with no other evidence of RG-7388 TB is not recommended [8]. Baseline chest radiographs in asymptomatic individuals with no prior tuberculosis history are not routinely indicated, although they may be considered in those at increased risk of TB (e.g. those from a highly endemic group or with a known contact history). Routine baseline chest films should be performed in those with a history of previous chest disease (including Pneumocystis) and may be considered in those at increase risk of TB (e.g. those from a highly endemic group or with a known contact history) and in those who have used intravenous drugs (IV). All patients

with a CD4 T-cell count of less than 200 cells/μL should have Toxoplasma serology (IgG titres) performed. If the test is IgG positive (consistent with previous exposure), then no repeat testing is required. GSK126 in vitro If the test is IgG negative, then the serology should be repeated if the CD4 T-cell count declines to below 100 cells/μL (as this result will be useful in determining the optimal prophylaxis for the patient). If the patient remains seronegative for Toxoplasma then the serology should be repeated annually while the CD4 T-cell count remains below 100 cells/μL. All patients with a CD4 T-cell count of less than 200 cells/μL should have Toxoplasma serology performed. If

Aurora Kinase the test is negative, this should be repeated yearly if the CD4 T-cell count is less than 100 cells/μL (III). There is relatively little information on the interactions between HIV and helminth or other tropical infections, and very scanty data on the sensitivities and specificities of routine assays for these coinfections in the setting of HIV infection [9, 10]. There is some evidence that urogenital schistosomiasis is associated with an increased risk of HIV transmission [9, 11], but there is presently insufficient evidence to assess whether there are any detrimental effects of other tropical infections on HIV infection, and insufficient data on whether routinely de-worming patients has a beneficial effect on HIV viral load, CD4 cell count or clinical progression [12].

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