101 Community-based testing of migrants for infectious diseases (COMBAT-ID): the effectiveness of routine testing for infectious diseases among migrants attending primary care

Abstract OP 34: Diseases and Interventions 2, B304 (FCSH), September 5, 2025, 10:15 - 11:15 Background Migrants are at increased risk of chronic infections and have poorer outcomes. Early diagnosis and management can reduce morbidity, mortality and onward infection transmission. Methods We evaluated the effectiveness of an integrated approach to screening migrants for exposure to tuberculosis (TB) with an interferon gamma release assay (IGRA) test, HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection when patients first registered with general practices (GPs) in Leicester, UK, using test yields, numbers of new diagnoses and numbers linked to care. Findings 4004 new migrant GP patients referred for testing were included (74% <36 years, 53% female, with a range of self-reported ethnicities: 63% Asian ethnicities, 9% Black ethnicities, 5% White and 12% Mixed/Other). Test yield was 0·48% (17/3545, 95%CI 0·30-0·77%) for HIV, 3·34% (117/3502, 95%CI 2·80-3·99%) for HBV and 0·18% (6/3402, 0·08-0·38%) for HCV, with 19·38% (496/2560, 95%CI 17·89-20·95%) positive on the IGRA test. There were two HIV-HBV, three HIV-TB and 19 HBV-TB coinfections. Of IGRA-positive patients attending clinic, 7% had active TB and 92% had latent TB infection. 55% of active TB, 99% of latent TB, 61% of HBV, 35% of HIV and 83% of HCV infections were new diagnoses. There were high rates of linkage to care for those newly diagnosed. 98% of new latent TB patients were offered chemoprophylaxis, of whom 94% started treatment and of these, 95% completed the course. 100%, 97% and 100% of newly HIV-, HBV- and HCV-diagnosed patients attended follow-up, respectively. Interpretation: This first primary care-based combined infection testing programme for recent migrants found high test yields for latent/active TB, HBV and HIV, substantial numbers of new diagnoses for these infections and excellent linkage to care. To influence UK screening guidelines, its cost-effectiveness and acceptability to other primary care settings must be evaluated.