Barcelona Institute for Global Health: Expanded TB screening does not speed up treatment initiation or improve survival in hospitalised patients with HIV

May 19, 2026 - 07:51

A new study from the Barcelona Institute for Global Health has found that expanding tuberculosis screening with molecular tests on sputum, urine, and stool samples does not lead to faster treatment initiation or better survival rates in hospitalised patients with HIV. The research challenges the assumption that more aggressive diagnostic testing would improve outcomes for this vulnerable population.

The standard approach recommended by the World Health Organisation relies on a specific diagnostic pathway. The study compared this method against a broader strategy that added molecular testing on multiple sample types. Despite the increased sensitivity of the expanded screening, it did not outperform the standard WHO-recommended approach in terms of getting patients onto treatment sooner or reducing mortality.

Researchers noted that while the additional tests did identify more TB cases, the delay in starting treatment was not significantly reduced. This suggests that other factors, such as the severity of illness at hospital admission or logistical barriers to care, may play a larger role in patient outcomes than the diagnostic method itself. The findings indicate that simply adding more sensitive tests may not be the most effective way to improve care for hospitalised HIV patients with suspected TB. The study calls for a re-evaluation of screening protocols, focusing instead on addressing the systemic bottlenecks that prevent rapid treatment initiation.