Operational Handbooks

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.

3.1.1 Frequency of screening

2.5.1 Adopt indicators and set targets for collaborative TB/HIV activities

2.4.1 Jointly develop policies, guidelines and procedures for collaborative TB/HIV activities

2.3.1 Identify priority comorbidities and interventions

2.2.1 Assess the joint burden of TB and HIV

2.1.1 Strengthen political commitment, coordination and accountability for collaborative action on TB and HIV

Table 1.1 summarizes all existing WHO recommendations² that relate to HIV-associated TB in adults, as published in the WHO consolidated guidelines on tuberculosis. Module 6: tuberculosis and comorbidities. HIV-associated TB (in press). Some recommendations will however also be relevant for children and adolescents. A full summary of recommendations on HIV-associated TB for children and adolescents specifically, can be found in the WHO consolidated guidelines on tuberculosis. Module 5: management of TB in children and adolescents (8).

The development of the section on HIV-associated TB (hereinafter referred to as the TB/HIV section) was coordinated by the WHO Global Tuberculosis Programme in collaboration with the Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes. A WHO steering group was set up in 2022 to guide the development of the TB/HIV section, and a stakeholder consultation with a broad array of experts was convened in September 2022, to inform the drafting process.