Care cascade of tuberculosis infection treatment for people living with HIV in the era of antiretroviral therapy scale-up

Kuan-Yin LinChia-Jui YangHsin-Yun SunYuan-Ti LeeBo-Huang LiouIng-Moi HiiTun-Chieh ChenSung-Hsi HuangChun-Yuan LeeChin-Shiang TsaiChi-Ying LinChun-Eng LiuHsi-Yen ChangChien-Yu ChengPo-Liang LuChien-Ching HungYu-Shan HuangWang-Da LiuGuan-Jhou ChenWen-Chun LiuYi-Ching SuPei-Ying WuLing-Ya ChenJun-Yu ZhangMao-Song TsaiChia-Chun LinYu-Lin LeeYen-Hsu ChenYi-Chia HuangWen-Chien KoShu-Hsing ChengSui-Yuan ChangNing-Chi WangTe-Yu LinYi-Chieh LeeShih-Ping LinChia-Yin HsiehHsiu-Wen WangMao-Wang HoTung-Che HungHung-Chin TsaiHsi-Hsun LinChen-Hsiang Lee2026-02-022026-02-022022-09-2710.1038/s41598-022-20394-2https://scholars.csmu.edu.tw/handle/123456789/4514AbstractTesting and treatment of tuberculosis infection (TBI) are recommended for people living with HIV (PLWH). We aimed to evaluate the care cascade of TBI treatment among PLWH in the era of antiretroviral therapy (ART) scale-up. This retrospective study included adult PLWH undergoing interferon-gamma release assay (IGRA)-based TBI screening during 2019–2021. PLWH testing IGRA-positive were advised to receive directly-observed therapy for TBI after active TB disease was excluded. The care cascade was evaluated to identify barriers to TBI management. Among 7951 PLWH with a median age of 38 years and CD4 count of 616 cells/mm3, 420 (5.3%) tested positive and 38 (0.5%) indeterminate for IGRA. The TBI treatment initiation rate was 73.6% (309/420) and the completion rate was 91.9% (284/309). More than 80% of PLWH concurrently received short-course rifapentine-based regimens and integrase strand transfer inhibitor (InSTI)-containing ART. The main barrier to treatment initiation was physicians’ concerns and patients’ refusal (85.6%). The factors associated with treatment non-completion were older age, female, anti-HCV positivity, and higher plasma HIV RNA. Our observation of a high TBI completion rate among PLWH is mainly related to the introduction of short-course rifapentine-based regimens in the InSTI era, which can be the strategy to improve TBI treatment uptake.[SDGs]SDG3[SDGs]SDG5Care cascade of tuberculosis infection treatment for people living with HIV in the era of antiretroviral therapy scale-upjournal-article