Operational Handbooks

4.3 HIV prevention

4.3.1 Combination HIV prevention for people with diagnosed or presumed TB

National TB programmes should implement comprehensive HIV prevention strategies for their clients and their partners, or they should establish community and referral linkages as necessary. HIV preventive interventions by TB programmes or effective referral of people with TB to HIV programmes has been successfully implemented in many countries (162-164).

3.3 Algorithms for informing the decision to treat TB infection or TB disease among people living with HIV

For people living with HIV, screening and diagnostic algorithms should serve both to include TB disease to identify those requiring treatment and to exclude TB disease to determine eligibility for TPT. Lack of access to any of the tools described here should not be a barrier to TB screening or ruling out TB to allow initiation of TPT. Here we present five practical algorithms that combine WHO-recommended TB screening tools (W4SS, CRP, CXR and mWRD) with diagnostic tools (LF-LAM and mWRD) for people living with HIV.