Risk factors for treatment default in close contacts with latent tuberculous infection

Christina T. Fiske, F. X. Yan, Y. Hirsch-Moverman, T. R. Sterling, M. R. Reichler, I. Bakhtawar, C. LeDoux, J. McAuley, J. Beison, J. M. FitzGerald, M. Naus, M. Nakajima, N. Schluger, J. Moran, H. Blumberg, J. Tapia, L. Singha, E. Hershfeld, B. Roche, B. ManguraA. Sevilla, T. Chavez-Lindell, F. Maruri, S. Dorman, W. Cronin, E. Munk, B. Chen, Y. Yuan, F. Yan, Y. Shen, H. Zhao, H. Zhang, M. Fagley, M. Reichler, C. Hirsch, C. Luo

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: 1) To characterize risk factors for non-completion of latent tuberculous infection treatment (LTBIT), and 2) to assess the impact of LTBIT regimens on subsequent risk of tuberculosis (TB). METHODS: Close contacts of adults aged ≥15 years with pulmonary TB were prospectively enrolled in a multi-center study in the United States and Canada from January 2002 to December 2006. Close contacts of TB patients were screened and cross-matched with TB registries to identify those who developed active TB. RESULTS: Of 3238 contacts screened, 1714 (53%) were diagnosed with LTBI. Preventive treatment was recommended in 1371 (80%); 1147 (84%) initiated treatment, of whom 723 (63%) completed it. In multivariate analysis, study site, initial interview sites other than a home or health care setting and isoniazid preventive treatment (IPT) were significantly associated with non-completion of LTBIT. Fourteen TB cases were identified in contacts, all of whom initiated IPT: two TB cases among persons who received ≥6 months of IPT (66 cases/100 000 person-years [py]), and nine among those who received 0-5 months (median 2 months) of IPT (792 cases/100 000 py, P <0.001); data on duration of IPT were not available for three cases. CONCLUSION: Only 53% (723/1371) of close contacts for whom IPT was recommended actually completed treatment. Close contacts were significantly less likely to complete LTBIT if they took IPT. Less than 6 months of IPT was associated with increased risk of active TB.

Original languageEnglish (US)
Pages (from-to)421-427
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume18
Issue number4
DOIs
StatePublished - Apr 1 2014
Externally publishedYes

Fingerprint

Isoniazid
Infection
Tuberculosis
Therapeutics
Home Care Services
Pulmonary Tuberculosis
Canada
Registries
Multivariate Analysis
Interviews
Delivery of Health Care

Keywords

  • LTBI
  • Treatment effectiveness
  • Treatment non-completion

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases
  • Medicine(all)

Cite this

Fiske, C. T., Yan, F. X., Hirsch-Moverman, Y., Sterling, T. R., Reichler, M. R., Bakhtawar, I., ... Luo, C. (2014). Risk factors for treatment default in close contacts with latent tuberculous infection. International Journal of Tuberculosis and Lung Disease, 18(4), 421-427. https://doi.org/10.5588/ijtld.13.0688

Risk factors for treatment default in close contacts with latent tuberculous infection. / Fiske, Christina T.; Yan, F. X.; Hirsch-Moverman, Y.; Sterling, T. R.; Reichler, M. R.; Bakhtawar, I.; LeDoux, C.; McAuley, J.; Beison, J.; FitzGerald, J. M.; Naus, M.; Nakajima, M.; Schluger, N.; Moran, J.; Blumberg, H.; Tapia, J.; Singha, L.; Hershfeld, E.; Roche, B.; Mangura, B.; Sevilla, A.; Chavez-Lindell, T.; Maruri, F.; Dorman, S.; Cronin, W.; Munk, E.; Chen, B.; Yuan, Y.; Yan, F.; Shen, Y.; Zhao, H.; Zhang, H.; Fagley, M.; Reichler, M.; Hirsch, C.; Luo, C.

In: International Journal of Tuberculosis and Lung Disease, Vol. 18, No. 4, 01.04.2014, p. 421-427.

Research output: Contribution to journalArticle

Fiske, CT, Yan, FX, Hirsch-Moverman, Y, Sterling, TR, Reichler, MR, Bakhtawar, I, LeDoux, C, McAuley, J, Beison, J, FitzGerald, JM, Naus, M, Nakajima, M, Schluger, N, Moran, J, Blumberg, H, Tapia, J, Singha, L, Hershfeld, E, Roche, B, Mangura, B, Sevilla, A, Chavez-Lindell, T, Maruri, F, Dorman, S, Cronin, W, Munk, E, Chen, B, Yuan, Y, Yan, F, Shen, Y, Zhao, H, Zhang, H, Fagley, M, Reichler, M, Hirsch, C & Luo, C 2014, 'Risk factors for treatment default in close contacts with latent tuberculous infection', International Journal of Tuberculosis and Lung Disease, vol. 18, no. 4, pp. 421-427. https://doi.org/10.5588/ijtld.13.0688
Fiske, Christina T. ; Yan, F. X. ; Hirsch-Moverman, Y. ; Sterling, T. R. ; Reichler, M. R. ; Bakhtawar, I. ; LeDoux, C. ; McAuley, J. ; Beison, J. ; FitzGerald, J. M. ; Naus, M. ; Nakajima, M. ; Schluger, N. ; Moran, J. ; Blumberg, H. ; Tapia, J. ; Singha, L. ; Hershfeld, E. ; Roche, B. ; Mangura, B. ; Sevilla, A. ; Chavez-Lindell, T. ; Maruri, F. ; Dorman, S. ; Cronin, W. ; Munk, E. ; Chen, B. ; Yuan, Y. ; Yan, F. ; Shen, Y. ; Zhao, H. ; Zhang, H. ; Fagley, M. ; Reichler, M. ; Hirsch, C. ; Luo, C. / Risk factors for treatment default in close contacts with latent tuberculous infection. In: International Journal of Tuberculosis and Lung Disease. 2014 ; Vol. 18, No. 4. pp. 421-427.
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abstract = "OBJECTIVE: 1) To characterize risk factors for non-completion of latent tuberculous infection treatment (LTBIT), and 2) to assess the impact of LTBIT regimens on subsequent risk of tuberculosis (TB). METHODS: Close contacts of adults aged ≥15 years with pulmonary TB were prospectively enrolled in a multi-center study in the United States and Canada from January 2002 to December 2006. Close contacts of TB patients were screened and cross-matched with TB registries to identify those who developed active TB. RESULTS: Of 3238 contacts screened, 1714 (53{\%}) were diagnosed with LTBI. Preventive treatment was recommended in 1371 (80{\%}); 1147 (84{\%}) initiated treatment, of whom 723 (63{\%}) completed it. In multivariate analysis, study site, initial interview sites other than a home or health care setting and isoniazid preventive treatment (IPT) were significantly associated with non-completion of LTBIT. Fourteen TB cases were identified in contacts, all of whom initiated IPT: two TB cases among persons who received ≥6 months of IPT (66 cases/100 000 person-years [py]), and nine among those who received 0-5 months (median 2 months) of IPT (792 cases/100 000 py, P <0.001); data on duration of IPT were not available for three cases. CONCLUSION: Only 53{\%} (723/1371) of close contacts for whom IPT was recommended actually completed treatment. Close contacts were significantly less likely to complete LTBIT if they took IPT. Less than 6 months of IPT was associated with increased risk of active TB.",
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T1 - Risk factors for treatment default in close contacts with latent tuberculous infection

AU - Fiske, Christina T.

AU - Yan, F. X.

AU - Hirsch-Moverman, Y.

AU - Sterling, T. R.

AU - Reichler, M. R.

AU - Bakhtawar, I.

AU - LeDoux, C.

AU - McAuley, J.

AU - Beison, J.

AU - FitzGerald, J. M.

AU - Naus, M.

AU - Nakajima, M.

AU - Schluger, N.

AU - Moran, J.

AU - Blumberg, H.

AU - Tapia, J.

AU - Singha, L.

AU - Hershfeld, E.

AU - Roche, B.

AU - Mangura, B.

AU - Sevilla, A.

AU - Chavez-Lindell, T.

AU - Maruri, F.

AU - Dorman, S.

AU - Cronin, W.

AU - Munk, E.

AU - Chen, B.

AU - Yuan, Y.

AU - Yan, F.

AU - Shen, Y.

AU - Zhao, H.

AU - Zhang, H.

AU - Fagley, M.

AU - Reichler, M.

AU - Hirsch, C.

AU - Luo, C.

PY - 2014/4/1

Y1 - 2014/4/1

N2 - OBJECTIVE: 1) To characterize risk factors for non-completion of latent tuberculous infection treatment (LTBIT), and 2) to assess the impact of LTBIT regimens on subsequent risk of tuberculosis (TB). METHODS: Close contacts of adults aged ≥15 years with pulmonary TB were prospectively enrolled in a multi-center study in the United States and Canada from January 2002 to December 2006. Close contacts of TB patients were screened and cross-matched with TB registries to identify those who developed active TB. RESULTS: Of 3238 contacts screened, 1714 (53%) were diagnosed with LTBI. Preventive treatment was recommended in 1371 (80%); 1147 (84%) initiated treatment, of whom 723 (63%) completed it. In multivariate analysis, study site, initial interview sites other than a home or health care setting and isoniazid preventive treatment (IPT) were significantly associated with non-completion of LTBIT. Fourteen TB cases were identified in contacts, all of whom initiated IPT: two TB cases among persons who received ≥6 months of IPT (66 cases/100 000 person-years [py]), and nine among those who received 0-5 months (median 2 months) of IPT (792 cases/100 000 py, P <0.001); data on duration of IPT were not available for three cases. CONCLUSION: Only 53% (723/1371) of close contacts for whom IPT was recommended actually completed treatment. Close contacts were significantly less likely to complete LTBIT if they took IPT. Less than 6 months of IPT was associated with increased risk of active TB.

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