Uppal A, Rahman S, Campbell JR, et al. - The strongest known risk factor for tuberculosis (TB) is human immunodeficiency virus (HIV). Among people living with HIV (PLHIV), there has been an increase in the uptake of tuberculosis preventive treatment (TPT) in recent years. Researchers herein summarized the costs, risks, benefits, and impacts of TPT in this population.

• A systematic review and meta-analysis was conducted to synthesize relevant information.

• A total of 6,615 titles were identified; the final review was performed including 61 full texts.

• Quantile regression and a random effects meta-analysis were performed to report key trends in cost, effectiveness, and cost-effectiveness outcomes across studies and to determine key determinants of these outcomes.

• A wide variation was observed in values of model parameters.

• As per findings from quantile regression analyses, TPT appeared to have greater effectiveness at lowering active TB incidence and cost-effectiveness in high-income countries (HICs), relative to low- and middle-income countries (LMICs).

• For both LMICs and HICs, there was positive pooled incremental net monetary benefit, given a willingness-to-pay threshold of country-level gross domestic product (GDP) per capita; TPT was thus suggested as potentially cost-effective relative to no TPT, regardless of study setting.

• Apart from these quantitative results, conclusions from individual study described the effectiveness of providing TPT to PLHIV at averting TB disease and its cost-effectiveness when compared with not providing TPT.