Treatment of latent Mycobacterium tuberculosis infection in intravenous drug users co-infected with HIV

Francesca Sánchez; Montse Balagué; Patricia García de Olalla; José L. López Colomés; Vicente Martín; Rafael Guerrero; Andrés Marco; Joan A. Caylà

doi:10.1177/1757177409354732

Treatment of latent Mycobacterium tuberculosis infection in intravenous drug users co-infected with HIV

Francesca Sánchez, Montse Balagué, Patricia García de Olalla, José L. López Colomés, Vicente Martín, Rafael Guerrero, Andrés Marco, Joan A. Caylà

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Objective: This clinical trial, carried out among injection drug users and the HIV-infected with tuberculin skin test ≥ 5 mm, aimed to evaluate the compliance and tolerability of two preventive strategies against tuberculosis (TB). Methods: Study protocol prospectively compares adherence to nine months of daily therapy with isoniazid (9H) versus two months of daily therapy with rifampin plus pyrazinamide (2RZ) administered randomly. All patients were concurrently admitted to a methadone maintenance programme. To assess toxicity, liver function was monitored monthly. Results: From 305 assessable patients, those in 2RZ arm showed better adherence (84% vs. 59%, p < 0.0001). Results on liver toxicity did not show significant differences between 9H and 2RZ (4.5% vs. 6.9%; odds ratio = 1.58, 95% confidence interval = 0.42-7.24). Conclusion: 2RZ should be considered an option to prevent TB in selected groups of patients infected with HIV, such as injection drug users on methadone treatment.

Original language	English (US)
Pages (from-to)	12-18
Number of pages	7
Journal	Journal of Infection Prevention
Volume	11
Issue number	1
DOIs	https://doi.org/10.1177/1757177409354732
State	Published - Jan 2010
Externally published	Yes

Keywords

HIV infection
Injection drug users
Latent tuberculosis infection
Methadone maintenance treatment
Short-course therapy

ASJC Scopus subject areas

Health Policy
Public Health, Environmental and Occupational Health
Advanced and Specialized Nursing
Infectious Diseases

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title = "Treatment of latent Mycobacterium tuberculosis infection in intravenous drug users co-infected with HIV",

abstract = "Objective: This clinical trial, carried out among injection drug users and the HIV-infected with tuberculin skin test ≥ 5 mm, aimed to evaluate the compliance and tolerability of two preventive strategies against tuberculosis (TB). Methods: Study protocol prospectively compares adherence to nine months of daily therapy with isoniazid (9H) versus two months of daily therapy with rifampin plus pyrazinamide (2RZ) administered randomly. All patients were concurrently admitted to a methadone maintenance programme. To assess toxicity, liver function was monitored monthly. Results: From 305 assessable patients, those in 2RZ arm showed better adherence (84% vs. 59%, p < 0.0001). Results on liver toxicity did not show significant differences between 9H and 2RZ (4.5% vs. 6.9%; odds ratio = 1.58, 95% confidence interval = 0.42-7.24). Conclusion: 2RZ should be considered an option to prevent TB in selected groups of patients infected with HIV, such as injection drug users on methadone treatment.",

keywords = "HIV infection, Injection drug users, Latent tuberculosis infection, Methadone maintenance treatment, Short-course therapy",

author = "Francesca S{\'a}nchez and Montse Balagu{\'e} and {de Olalla}, {Patricia Garc{\'i}a} and {L{\'o}pez Colom{\'e}s}, {Jos{\'e} L.} and Vicente Mart{\'i}n and Rafael Guerrero and Andr{\'e}s Marco and Cayl{\`a}, {Joan A.}",

year = "2010",

month = jan,

doi = "10.1177/1757177409354732",

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AU - Sánchez, Francesca

AU - Balagué, Montse

AU - de Olalla, Patricia García

AU - López Colomés, José L.

AU - Martín, Vicente

AU - Guerrero, Rafael

AU - Marco, Andrés

AU - Caylà, Joan A.

PY - 2010/1

Y1 - 2010/1

N2 - Objective: This clinical trial, carried out among injection drug users and the HIV-infected with tuberculin skin test ≥ 5 mm, aimed to evaluate the compliance and tolerability of two preventive strategies against tuberculosis (TB). Methods: Study protocol prospectively compares adherence to nine months of daily therapy with isoniazid (9H) versus two months of daily therapy with rifampin plus pyrazinamide (2RZ) administered randomly. All patients were concurrently admitted to a methadone maintenance programme. To assess toxicity, liver function was monitored monthly. Results: From 305 assessable patients, those in 2RZ arm showed better adherence (84% vs. 59%, p < 0.0001). Results on liver toxicity did not show significant differences between 9H and 2RZ (4.5% vs. 6.9%; odds ratio = 1.58, 95% confidence interval = 0.42-7.24). Conclusion: 2RZ should be considered an option to prevent TB in selected groups of patients infected with HIV, such as injection drug users on methadone treatment.

AB - Objective: This clinical trial, carried out among injection drug users and the HIV-infected with tuberculin skin test ≥ 5 mm, aimed to evaluate the compliance and tolerability of two preventive strategies against tuberculosis (TB). Methods: Study protocol prospectively compares adherence to nine months of daily therapy with isoniazid (9H) versus two months of daily therapy with rifampin plus pyrazinamide (2RZ) administered randomly. All patients were concurrently admitted to a methadone maintenance programme. To assess toxicity, liver function was monitored monthly. Results: From 305 assessable patients, those in 2RZ arm showed better adherence (84% vs. 59%, p < 0.0001). Results on liver toxicity did not show significant differences between 9H and 2RZ (4.5% vs. 6.9%; odds ratio = 1.58, 95% confidence interval = 0.42-7.24). Conclusion: 2RZ should be considered an option to prevent TB in selected groups of patients infected with HIV, such as injection drug users on methadone treatment.

KW - HIV infection

KW - Injection drug users

KW - Latent tuberculosis infection

KW - Methadone maintenance treatment

KW - Short-course therapy

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Treatment of latent Mycobacterium tuberculosis infection in intravenous drug users co-infected with HIV

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Keywords

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