recommended process, the WHO HIV/ AIDS

As part of the Guideline Review Committee
(GRC)-recommended process, the WHO HIV/
AIDS and Stop TB Departments conducted
a global policy meeting on 25–27 January 2010 to
review the evidence regarding ICF and IPT, and to
reconceptualize the 1998 WHO/UNAIDS Policy on
TB prevention (Annexes 1–3). Key questions were
identified and a comprehensive review of the available
scientific evidence was conducted to formulate the
recommendations. A WHO Guidelines Group to review
the evidence and formulate the recommendations
was established and a comprehensive review of the
available scientific evidence for eight key questions
(see above) was prepared. Systematic literature
reviews of studies related to the eight questions
among people living with HIV were conducted using
PubMed, and various combinations of keywords were
used to search for studies related to each question. A
search was also conducted for abstracts presented at
conferences on TB and lung disease organized by the
International Union Against TB and Lung Disease (The
Union) and the International AIDS Society between
2000 and 2008. All retrieved titles and abstracts
were reviewed for their relevance to the topic in the
question. The reference lists of the retrieved studies
were also reviewed to identify further studies that met
the eligibility criteria. In addition, recognized experts in
the field were contacted to identify studies that were
not available (e.g. unpublished) in the initial electronic
search for each question.
The quality of evidence and strength of recommendation
was assessed using the Grading of Recommendations
Assessment, Development and Evaluation (GRADE)
methodology.[14] In the GRADE assessment process,
the quality of a body of evidence is defined as the
extent to which one can be confident that the reported
estimates of effect (desirable or undesirable) availablefrom the evidence are close to the actual effects of
interest. The usefulness of an estimate of the effect (of
the intervention) depends on the level of confidence in
that estimate. The higher the quality of evidence, the
more likely a strong recommendation can be made;
however, the decision regarding the strength of the
evidence also depends on other factors. Although
the GRADE evidence assessment process was used
for all of the questions, it was not always possible
to calculate GRADE profiles for all the questions
because there was a lack of data and information to
calculate the necessary risk ratios.