The impact of blood transcriptomic biomarker targeted tuberculosis preventive therapy in people living with HIV: a mathematical modelling study

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dc.contributor.authorSumner, Tom
dc.contributor.authorMendelsohn, Simon C.
dc.contributor.authorScriba, Thomas J.
dc.contributor.authorHatherill, Mark
dc.contributor.authorWhite, Richard G.
dc.date.accessioned2021-11-02T13:29:19Z
dc.date.available2021-11-02T13:29:19Z
dc.date.issued2021-10-29
dc.date.updated2021-10-31T04:18:32Z
dc.description.abstractBackground Tuberculosis (TB) preventive therapy is recommended for all people living with HIV (PLHIV). Despite the elevated risk of TB amongst PLHIV, most of those eligible for preventive therapy would never develop TB. Tests which can identify individuals at greatest risk of disease would allow more efficient targeting of preventive therapy. Methods We used mathematical modelling to estimate the potential impact of using a blood transcriptomic biomarker (RISK11) to target preventive therapy amongst PLHIV. We compared universal treatment to RISK11 targeted treatment and explored the effect of repeat screening of the population with RISK11. Results Annual RISK11 screening, with preventive therapy provided to those testing positive, could avert 26% (95% CI 13–34) more cases over 10 years compared to one round of universal treatment. For the cost per case averted to be lower than universal treatment, the maximum cost of the RISK11 test was approximately 10% of the cost of preventive therapy. The benefit of RISK11 screening may be greatest amongst PLHIV on ART (compared to ART naïve individuals) due to the increased specificity of the test in this group. Conclusions Biomarker targeted preventive therapy may be more effective than universal treatment amongst PLHIV in high incidence settings but would require repeat screening.en_US
dc.identifier.apacitationSumner, T., Mendelsohn, Simon C., Scriba, Thomas J., Hatherill, M., & White, Richard G. (2021). The impact of blood transcriptomic biomarker targeted tuberculosis preventive therapy in people living with HIV: a mathematical modelling study. <i>BMC Medicine</i>, 19(Article number: 252), http://hdl.handle.net/11427/35304en_ZA
dc.identifier.chicagocitationSumner, Tom, Simon C. Mendelsohn, Thomas J. Scriba, Mark Hatherill, and Richard G. White "The impact of blood transcriptomic biomarker targeted tuberculosis preventive therapy in people living with HIV: a mathematical modelling study." <i>BMC Medicine</i> 19, Article number: 252. (2021) http://hdl.handle.net/11427/35304en_ZA
dc.identifier.citationSumner, T., Mendelsohn, Simon C., Scriba, Thomas J., Hatherill, M. & White, Richard G. 2021. The impact of blood transcriptomic biomarker targeted tuberculosis preventive therapy in people living with HIV: a mathematical modelling study. <i>BMC Medicine.</i> 19(Article number: 252) http://hdl.handle.net/11427/35304en_ZA
dc.identifier.ris TY - Journal Article AU - Sumner, Tom AU - Mendelsohn, Simon C. AU - Scriba, Thomas J. AU - Hatherill, Mark AU - White, Richard G. AB - Background Tuberculosis (TB) preventive therapy is recommended for all people living with HIV (PLHIV). Despite the elevated risk of TB amongst PLHIV, most of those eligible for preventive therapy would never develop TB. Tests which can identify individuals at greatest risk of disease would allow more efficient targeting of preventive therapy. Methods We used mathematical modelling to estimate the potential impact of using a blood transcriptomic biomarker (RISK11) to target preventive therapy amongst PLHIV. We compared universal treatment to RISK11 targeted treatment and explored the effect of repeat screening of the population with RISK11. Results Annual RISK11 screening, with preventive therapy provided to those testing positive, could avert 26% (95% CI 13–34) more cases over 10 years compared to one round of universal treatment. For the cost per case averted to be lower than universal treatment, the maximum cost of the RISK11 test was approximately 10% of the cost of preventive therapy. The benefit of RISK11 screening may be greatest amongst PLHIV on ART (compared to ART naïve individuals) due to the increased specificity of the test in this group. Conclusions Biomarker targeted preventive therapy may be more effective than universal treatment amongst PLHIV in high incidence settings but would require repeat screening. DA - 2021-10-29 DB - OpenUCT DP - University of Cape Town IS - Article number: 252 J1 - BMC Medicine KW - Tuberculosis KW - HIV KW - Preventive therapy KW - Biomarker KW - Modelling LK - https://open.uct.ac.za PY - 2021 T1 - The impact of blood transcriptomic biomarker targeted tuberculosis preventive therapy in people living with HIV: a mathematical modelling study TI - The impact of blood transcriptomic biomarker targeted tuberculosis preventive therapy in people living with HIV: a mathematical modelling study UR - http://hdl.handle.net/11427/35304 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12916-021-02127-w
dc.identifier.urihttp://hdl.handle.net/11427/35304
dc.identifier.vancouvercitationSumner T, Mendelsohn Simon C, Scriba Thomas J, Hatherill M, White Richard G. The impact of blood transcriptomic biomarker targeted tuberculosis preventive therapy in people living with HIV: a mathematical modelling study. BMC Medicine. 2021;19(Article number: 252) http://hdl.handle.net/11427/35304.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Pathologyen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Medicineen_US
dc.source.journalissueArticle number: 252en_US
dc.source.journalvolume19en_US
dc.source.urihttps://bmcmedicine.biomedcentral.com/
dc.subjectTuberculosisen_US
dc.subjectHIVen_US
dc.subjectPreventive therapyen_US
dc.subjectBiomarkeren_US
dc.subjectModellingen_US
dc.titleThe impact of blood transcriptomic biomarker targeted tuberculosis preventive therapy in people living with HIV: a mathematical modelling studyen_US
dc.typeJournal Articleen_US
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