TY - JOUR
T1 - Duration of efficacy of treatment of latent tuberculosis infection in HIV-infected adults
AU - Johnson, John L.
AU - Okwera, Alphonse
AU - Hom, David L.
AU - Mayanja, Harriet
AU - Kityo, Cissy Mutuluuza
AU - Nsubuga, Peter
AU - Nakibali, Joseph G.
AU - Loughlin, Anita M.
AU - Yun, Hyun
AU - Mugyenyi, Peter N.
AU - Vernon, Andrew
AU - Mugerwa, Roy D.
AU - Ellner, Jerrold J.
AU - Whalen, Christopher C.
PY - 2001/11/9
Y1 - 2001/11/9
N2 - Background: Treatment of latent infection is needed to protect HIV-infected individuais against tuberculosis. A previous report addressed short-term efficacy of three regimens in HIV-infected adults. We now report on long-term efficacy of the study regimens. Methods: Three daily self-administered regimens were compared in a randomized placebo-controlled trial in 2736 purified protein derivative (PPD)-positive and anergic HIV-infected adults. PPD-positive subjects were treated with isoniazid (INH) for 6 months (6H), INH plus rifampicin for 3 months (3HR), INH plus rifampicin and pyrazinamide for 3 months (3HRZ), or placebo for 6 months. Anergic subjects were randomized to 6H or placebo. Results: 6H initially protected against tuberculosis in PPD-positive individuals; however, benefit was lost within the first year of treatment. Sustained benefit was observed in persons receiving 3HR and 3HRZ. In a Cox regression analysis, the adjusted relative risk for tuberculosis compared with placebo was 0.67 [95% confidence interval (CI), 0.42-1.07] for 6H, 0.49 (95% Cl, 0.29-0.82) for 3HR, and 0.41 (95% Cl, 0.22-0.76) for 3HRZ. When the rifampicin-containing regimens were combined, the adjusted relative risk for tuberculosis compared with placebo was 0.46 (95% Cl, 0.29-0.71). Among anergic subjects, a modest degree of protection with 6H was present (adjusted relative risk, 0.61; 95% Cl, 0.32-1.16). Treatment of latent tuberculosis infection had no effect on mortality. Conclusion: Six months of INH provided short-term protection against tuberculosis in PPD-positive HIV-infected adults. Three month regimens including INH plus rifampicin or INH, rifampicin and pyrazinamide provided sustained protection for up to 3 years.
AB - Background: Treatment of latent infection is needed to protect HIV-infected individuais against tuberculosis. A previous report addressed short-term efficacy of three regimens in HIV-infected adults. We now report on long-term efficacy of the study regimens. Methods: Three daily self-administered regimens were compared in a randomized placebo-controlled trial in 2736 purified protein derivative (PPD)-positive and anergic HIV-infected adults. PPD-positive subjects were treated with isoniazid (INH) for 6 months (6H), INH plus rifampicin for 3 months (3HR), INH plus rifampicin and pyrazinamide for 3 months (3HRZ), or placebo for 6 months. Anergic subjects were randomized to 6H or placebo. Results: 6H initially protected against tuberculosis in PPD-positive individuals; however, benefit was lost within the first year of treatment. Sustained benefit was observed in persons receiving 3HR and 3HRZ. In a Cox regression analysis, the adjusted relative risk for tuberculosis compared with placebo was 0.67 [95% confidence interval (CI), 0.42-1.07] for 6H, 0.49 (95% Cl, 0.29-0.82) for 3HR, and 0.41 (95% Cl, 0.22-0.76) for 3HRZ. When the rifampicin-containing regimens were combined, the adjusted relative risk for tuberculosis compared with placebo was 0.46 (95% Cl, 0.29-0.71). Among anergic subjects, a modest degree of protection with 6H was present (adjusted relative risk, 0.61; 95% Cl, 0.32-1.16). Treatment of latent tuberculosis infection had no effect on mortality. Conclusion: Six months of INH provided short-term protection against tuberculosis in PPD-positive HIV-infected adults. Three month regimens including INH plus rifampicin or INH, rifampicin and pyrazinamide provided sustained protection for up to 3 years.
KW - Antitubercular agents
KW - HIV
KW - Isoniazid
KW - Prevention and control
KW - Pyrazinamide
KW - Rifampicin
KW - Tuberculin
KW - Tuberculosis
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U2 - 10.1097/00002030-200111090-00009
DO - 10.1097/00002030-200111090-00009
M3 - Article
C2 - 11684933
AN - SCOPUS:0035834533
SN - 0269-9370
VL - 15
SP - 2137
EP - 2147
JO - AIDS
JF - AIDS
IS - 16
ER -