Tuberculosis screening and treatment compliance in human immunodeficiency virus patients

This study aims to evaluate compliance of hiv patients to tb screening and treatment,identifying determinants for non-compliance.we reviewed clinical records of all hiv infected patients first attended in a portuguese-infectious-unit from 2007-2010 (152 patients). screening included: symptom inquiry,chest x-ray,tst/igra. in 2008 a protocol was established with a tb outpatient clinic allowing patients to choose where to perform screening (decentralization).all patients were offered screening,69 (45.4%) accepted. before decentralization,out of 78 patients,20 (25%) accepted screening. after decentralization,out of 64 patients,49 (76.6%) accepted screening. decentralization was associated with higher levels of acceptance (p. <. 0.001),having an aids-defining-disease (p. =0.002) and being older (p. =0.04) was associated with lower screening acceptance. ltbi was diagnosed in 14 and active-tb in 18 cases; 14 cases of active-tb were later diagnosed during hospital appointments. for active-tb,being on haart was related with treatment adherence (p. =0.03).in this population,improving health care access was important for screening compliance. © 2012 sociedade portuguesa de pneumologia.