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
Publication statusPublished - Apr 1 2014
Externally publishedYes

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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