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TB Satellite Session at the 9th SA AIDS Conference

Date: 
13 Jun 2019
Location: 
ICC Durban

Tackling TB and HIV co-infection in low-resource settings: Use of urine lipoarabinomannan assay (U-LAM) to diagnose and screen for active TB in people living with HIV with advanced disease

Date: Thursday, June 13th, 2019
Time:  14:00 - 15:30
Venue: Hall 2, International Convention Centre (ICC) Hall No. 2F, Durban    
Chairperson and moderator: Mr David Mametja

Background

Tuberculosis (TB) is a leading cause of death among people living with HIV (PLHIV) in countries with high TB prevalence rates, including South Africa. Ending HIV-associated TB among PLHIV is possible through a combination of ART coverage, early identification and treatment of TB, TB preventive therapy (TPT) and effective infection control activities. Failure to rapidly detect TB co-infection in PLHIV with advanced disease threatens patients’ lives, increases risk of mortality and intensifies both personal and public healthcare costs. Accurate and rapid diagnosis of active TB supports patients to access the care they need. It also reduces transmission and supports timeous decision-making about initiating patients on antiretroviral therapy (ART).

Although critical to TB management efforts, diagnosing TB in PLHIV is challenging. In reality, it is physically difficult to collect sputum samples from severely ill patients – both HIV-positive and HIV-negative – and samples are often paucibacillary. Alternative techniques are, therefore, necessary to efficiently diagnose TB.

The lateral flow urine lipoarabinomannan assay (U-LAM) is a point-of-care test that detects lipoarabinomannan (LAM), a lipopolysaccharide present in mycobacterial cell walls in people with active TB disease. U-LAM can increase TB diagnosis yield and predict the mortality rate of TB infection, particularly in patients with advanced HIV.

Addressing critical gaps and missed opportunities to ensure effective and early diagnosis and treatment as well as TB preventive therapies is critical to prevent and treat TB among PLHIV.

Objectives

This satellite session provides a platform for discussions about the advances in implementing U-LAM to diagnose TB in HIV co-infected individuals specifically. Presentations will highlight the South Africa National TB Programme’s uptake and roll-out of the approach and its impact on patient care. The session will also explore opportunities and challenges in integrating U-LAM diagnostics in TB management services to better serve PLHIV with advanced disease in low-resource settings. Finally, presentations will aim to facilitate understanding of the value-add of U-LAM diagnostics in South Africa’s TB management algorithms and recent developments in TB preventive therapies.