April 10, 2019 – Tuberculosis (TB) is the number-one killer of people living with HIV. Using TB lipoarabinomannan (LAM) tests, an inexpensive, urine-based test, has been proven to decrease mortality rates and allow for earlier diagnosis among people living with HIV (PLHIV). Yet, TB LAM testing is underrepresented in countries that are supported by President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, TB, and Malaria.
As people with advanced HIV are much more likely to have disseminated TB (TB outside of the lungs) and to die from TB without receiving a diagnosis, it’s particularly important for more countries to adopt the TB LAM test as a diagnostic method for all PLHIVs presenting to hospitals regardless of CD4 count and all PLHIVs presenting to ambulatory care with signs of advanced disease or with CD4<200 cell/mm3.
Our two briefs, The LAM Test: Ensuring Scaled-Up, Expanded TB LAM Testing for People Living With Advanced HIV for Country Programs and The LAM Test: Ensuring Scaled-Up, Expanded TB LAM Testing for People Living With Advanced HIV for Donors, offer scientific evidence of the benefits of TB LAM testing, share an analysis of PEPFAR and Global Fund grants for the inclusion of TB LAM testing, and outline potential steps that countries and donors can take to make sure national TB programs can easily access this life-saving test.