Department of Health and Population Sciences, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, United Kingdom.
Department of Respiratory Medicine, Royal Free London NHS Foundation Trust, Pond Street, London NW3 2QG, United Kingdom.
J Infect. 2015 Apr;70(4):317-23. doi: 10.1016/j.jinf.2014.10.014. Epub 2014 Nov 5.
Testing for HIV is a standard of care for people with active tuberculosis (TB). People investigated for TB in the UK often originate from areas with a high prevalence of HIV and other blood borne viruses (BBV). However, assessment for these infections is patchy. We determined the yield and costs of different testing strategies for BBV in a UK TB clinic.
Since 2009, it has been routine to test all TB clinic attendees. Demographic, clinical and virological data were retrospectively extracted from patient notes and hospital databases.
Over 3 years, 1036 people were assessed in the TB service. 410 had a final diagnosis of active TB. HIV testing of the latter population diagnosed 27 new HIV cases at a cost of £3017. When BBV testing was offered to all clinic attendees, a further 6 (total 33) new HIV, 5 Hepatitis B (HBV) and 2 Hepatitis C (HCV) diagnoses were made at a total cost of £22,170.
We have identified previously undiagnosed HIV, HBV and HCV in a TB clinic population. Our data suggest that despite increasing upfront expense, the associated yield argues strongly for BBV testing to be offered to all patients being investigated for possible TB, irrespective of their final diagnosis.
对活动性肺结核（TB）患者进行 HIV 检测是常规治疗方法。在英国，接受 TB 调查的人群通常来自 HIV 和其他血源病毒（BBV）流行率较高的地区。然而，这些感染的评估并不完善。我们在英国的一家 TB 诊所确定了不同 BBV 检测策略的收益和成本。
自 2009 年以来，对所有 TB 诊所就诊者进行常规检测。从患者病历和医院数据库中回顾性提取人口统计学、临床和病毒学数据。
在 3 年期间，TB 服务共评估了 1036 人。410 人最终诊断为活动性 TB。对后一组人群进行 HIV 检测，共诊断出 27 例新的 HIV 病例，花费为 3017 英镑。当向所有诊所就诊者提供 BBV 检测时，又发现了 6 例（总计 33 例）新的 HIV、5 例乙型肝炎（HBV）和 2 例丙型肝炎（HCV）病例，总费用为 22170 英镑。
我们在 TB 诊所人群中发现了以前未诊断出的 HIV、HBV 和 HCV。我们的数据表明，尽管前期费用增加，但相关收益强烈支持对所有疑似 TB 的患者提供 BBV 检测，而不论其最终诊断如何。
