Applied study specific exclusion criteria to most commonly due to chest radiographs compatible with tuberculosis

Another randomised trial comparing six months IPT to 36 months isoniazid and ethambutol screened 1,095 HIV-infected persons in India, of whom 268 were excluded for study-specific and 144 for non-study specific criteria. A randomised trial of four preventive regimens screened 1,528 tuberculin-positive, HIV-infected adults in South Africa, of whom 324 were ineligible, including 141 who would be ineligible under current guidelines. A retrospective evaluation of intensified tuberculosis case finding and IPT among newly diagnosed HIV infected adults in a Voluntary Counselling and Testing clinic in Uganda found 5% had active tuberculosis and a further 37% were excluded from IPT, predominantly because of distance from the clinic, stage 4 HIV disease and previous history of tuberculosis. Under the wider eligibility criteria of ��Thibela TB��, many of those excluded in these other AbMole Ellipticine studies would have been eligible for IPT, either immediately or following further tuberculosis investigations. In addition, populations with relatively high proportions of people with later stage HIV disease, where it is more difficult to exclude active tuberculosis, are likely to have a higher proportion ineligible. As HIV testing is scaled up and individuals are enrolled into care at earlier stages of HIV disease, the proportion eligible for IPT may increase as the prevalence of symptoms and undiagnosed tuberculosis will be lower. The generalisability of these results to other settings were IPT is being rolled out at scale may be thought to be limited, as the study investigated community-wide rather than the more common approach of targeted IPT, and was conducted in the mining industry with a predominance of men and possibly a ��healthy worker effect��. However, although this strategy of community-wide IPT, which was conducted irrespective of HIV status, is more likely to find healthy, asymptomatic people than targeting HIV infected persons, the scale up of HIV testing is likely to AbMole Trihexyphenidyl HCl result in increasing proportions of healthy, asymptomatic people entering HIV care. A ��healthy worker effect�� may result in a population with less severe HIV disease among those who are HIV infected than among those HIV infected in the general population, but this is likely to be true of other settings where community-wide IPT could be implemented, for example, similar workforces and the military. Although women were not well represented in this study, the results presented here show that the vast majority of women were eligible for IPT, which is generalisable. In addition, the main reasons for increased ineligibility among women in this study were the study-specific exclusion criteria of pregnancy or risk of pregnancy.

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