# Closing -TB GAPs - for people living with HIV: TB Guidance for Adaptable Patient-Centered Service

> **NIH ALLCDC U01** · BAYLOR COLLEGE OF MEDICINE · 2022 · $750,000

## Abstract

PROJECT SUMMARY
 Tuberculosis (TB) is the world’s leading infectious cause of mortality and responsible for 1/3 of deaths in
people living with HIV (PLHIV). Children and adolescents living with HIV are disproportionately affected due to
inadequate preventive services, large case detection gaps, adherence challenges, and knowledge gaps. Our
project will generate evidence to inform interventions targeting these weaknesses in the TB/HIV cascade of care.
 Early detection and treatment of TB improves outcomes in PLHIV. A key challenge in the detection of
HIV-associated TB has been implementation of screening that identifies the correct population to complete
diagnostic testing. Increasing evidence demonstrates the poor performance of recommened symptom screens
and diagnostic approaches. Hence, we aim to define a more accurate TB screening and testing strategy among
PLHIV.
 TB preventive treatment (TPT) averts HIV-associated TB. Nevertheless, among PLHIV, TPT initiation
and completion rates are sub-optimal and effective delivery strategies are not defined. As such, we aim to identify
the most effective TPT delivery strategy by leveraging approaches effective at improving HIV treatment
adherence.
 Although evidence demonstrates that isoniazid preventive therapy is cost-effective in young children
living in a TB/HIV high burden setting, the cost-effectiveness of newer short-course TPT has primarily been
studied in the context of a TB low-burden, high income setting. We aim to generate evidence to fill this gap and
inform policy.
 To ensure that our work makes a sustainable impact, we will provide mentorship on best practices in
accordance with evolving country guidelines and harnessing the proven capacity of our indigenous Baylor
Foundation partners to provide quality mentorship on HIV associated TB care. As a regional leader in HIV
associated TB care, we will develop an online resource that will serve as the TB GAPS Echo Hub to provide
regional expert consultation, guideline updates, and emerging evidence for providers managing children and
adolescents with HIV associated TB in the region.
 Our team is uniquely positioned to develop, implement, and evaluate evidence-based, innovative
approaches to prevent, find, and cure HIV-associated TB in five CDC target priority countries. Our proposed
project capitalizes upon our well-harmonized clinical network that is linked with a common electronic medical
record to maximize project deliverables.

## Key facts

- **NIH application ID:** 10437583
- **Project number:** 5U01GH002278-03
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** ANNA M MANDALAKAS
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2022
- **Award amount:** $750,000
- **Award type:** 5
- **Project period:** 2020-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10437583

## Citation

> US National Institutes of Health, RePORTER application 10437583, Closing -TB GAPs - for people living with HIV: TB Guidance for Adaptable Patient-Centered Service (5U01GH002278-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10437583. Licensed CC0.

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