in_the_evidence

In children living with HIV who are less than 12 months of age, only those who have contact with a
TB case and who are evaluated for TB (using investigations) should receive six months IPT if the
evaluation shows no TB disease.

Children living with HIV who are more than 12 months of age and who are unlikely to have active
TB on symptom-based screening and have no contact with a TB case should receive six months
of IPT (10mg/kg/day) as part of a comprehensive package of HIV prevention and care services.

Adults and adolescents living with HIV should be screened for TB with a clinical algorithm; those
who report any one of the symptoms of current cough, fever, weight loss or night sweats may have
active TB and should be evaluated for TB and other diseases.

Routine HIV testing should be offered to all patients with presumptive and diagnosed TB.

The GRADE evidence assessment confirmed that the quality of evidence for
commercial serodiagnostic tests was very low, with harms/risks far outweighing any potential benefits. It is therefore recommended that these tests should not be used
in individuals suspected of active pulmonary or extra-pulmonary TB, irrespective of their HIV status.

TB patients should be screened for diabetes at the start of TB treatment,
where resources for diagnosis are available. Type of screening and
diagnostic tests should be adapted to the context of local health
systems and the availability of resources, while awaiting additional
evidence on the best screening and diagnostic approach.

Treatment and case management of TB in people with diabetes should
be provided in accordance with existing TB treatment guidelines and
international standards. The same TB treatment regimen should be
prescribed to people with diabetes as for people without diabetes.

Screening for active TB on broader indications (for example in all people
diagnosed with diabetes, regardless of symptoms) should be explored
as part of the research agenda for improved TB diagnosis among people
with diabetes.

Establish and provide adequate financial resources for prevention, treatment, care and support programmes to prevent the occupational or non-occupational transmission of HIV and TB among health workers.

Adapt and implement good practices in occupational health and the management of HIV and TB in
the workplace from all sectors.