Please select the option that best describes you:
What is your approach to a positive PPD or IGRA in a patient with well-controlled HIV without significant TB risk factors?
Answer from: at Community Practice
I would treat this patient for LTBI (after ruling out active disease); if the patient was hesitant to be treated, a second test could be done if it would increase their likelihood of adhering to the regimen; but I would urge treatment in any case as the stakes are high if untreated LTBI is present.
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Answer from: at Community Practice
I treat all HIV patients with positive screening tests. I consider HIV itself, regardless of CD4 count, to be the highest risk for reactivation disease. I believe there is data showing this risk to be higher even than organ transplant or cancer treatment patients.
The problem of course is navigatin...
Answer from: at Community Practice
In an HIV patient without significant risk factors (CD4 nadir >300, no comorbidities), I would offer and encourage treatment for latent Tb but probably not push too hard. For patients who who were willing, I would offer 4 months of rifampin. This would often necessitate changing their ART to dolu...