Implementing isoniazid preventive therapy in a tuberculosis treatment-experienced cohort on ART

Maharaj, Bhavna; Gengiah, Tanuja N.; Yende‐Zuma, Nonhlanhla; Gengiah, Santhanalakshmi; Naidoo, Anushka; Naidoo, Kogieleum

doi:10.5588/ijtld.16.0775

Cited by 21 publications

(25 citation statements)

References 27 publications

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“…[ 9 20 21 ] Earlier, a qualitative study in Ethiopia concluded that integration of health system services was important factor to improve adherence and IPT completion rate[ 22 ] A prospective study in South Africa evaluating cohort of TB treatment-experienced HIV-infected patients in ART visits found a higher IPT completion rate of 86.8% when IPT visits were successfully integrated with existing ART visits. [ 23 ]…”

Section: Discussionmentioning

confidence: 99%

Implementation of isoniazid preventive therapy among people living with HIV in Northwestern Nigeria: Completion rate and predictive factors

Adepoju

Ogbudebe

Adejumo

et al. 2020

J Global Infect Dis

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Background: Despite proven benefits of isoniazid preventive therapy (IPT) for people living with HIV (PLHIV), its implementation remains limited in low-resource settings. There are also programmatic concerns of the completion rate of IPT particularly when full integration with other HIV services has not been achieved. Aim: The aim of this study was to determine the completion rate of IPT and predictive factors among PLHIV attending six government hospitals in Kebbi state, Northern Nigeria. Methods: This was a retrospective cohort study of program data spanning a 5-year period (December 2010–June 2016). Data were collected between January 2017 and June 2017. Results: A total of 1,134 IPT patients were enrolled of whom 740 (65.3%) were female. The mean age was 40.3 ± 3.7 years. Four hundred and fifty-four (40%) of those who initiated IPT completed the 6-month course. Of the 680 (60%) IPT noncompleters, 117 (17.2%) were lost to follow-up by month 1, 305 (44.9%) by month 2, 156 (22.9%) by month 3, 48 (7.1%) by month 4, and 54 (7.9%) by month 5. Being initiated on IPT by a pharmacist (adjusted odds ratio [aOR]: 23.7, 95% confidence interval [CI]: 16.5–33.9) and receiving ≤2 tuberculosis screening evaluation during IPT period (aOR: 0.58, 95% CI: 0.43–0.78) were associated with a higher and lower risk of completing IPT, respectively, whereas age, sex, and anti-retroviral therapy (ART) status were not significantly associated. Conclusion: IPT completion rate among PLHIV is relatively low, highlighting the need to strengthen IPT rollout in public health facilities in Nigeria. Pharmacy-led IPT adherence education and regular clinical evaluation may improve IPT completion rates, along with synchronizing and prepackaging IPT and ART resupplies for PLHIV.

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Section: Discussionmentioning

confidence: 99%

Implementation of isoniazid preventive therapy among people living with HIV in Northwestern Nigeria: Completion rate and predictive factors

Adepoju

Ogbudebe

Adejumo

et al. 2020

J Global Infect Dis

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“…The first was the TB Recurrence upon Treatment with HAART (TRuTH) CAPRISA 005 study (Maharaj et al, 2017; Sivro et al, 2017). This prospective cohort study, conducted between 2009 and 2013, aimed to assess risk factors associated with progression to recurrent TB disease during a 3-year longitudinal follow up in HIV-infected persons who began ART during treatment of the previous TB episode.…”

Section: Methodsmentioning

confidence: 99%

“…This opened the possibility to evaluate the COR signature in rare longitudinal cohorts from whom only biobanked PBMCs are available. In this study we aimed to determine the prognostic value of this 11-gene COR signature for recurrent TB in people living with HIV who participated in the “TB Recurrence upon Treatment with HAART” (TRuTH) study conducted at the Centre for the Aids Programme of Research In South Africa (CAPRISA) in Durban, South Africa (Maharaj et al, 2017; Sivro et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Detection of Tuberculosis Recurrence, Diagnosis and Treatment Response by a Blood Transcriptomic Risk Signature in HIV-Infected Persons on Antiretroviral Therapy

et al. 2019

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HIV-infected individuals are at high risk of tuberculosis disease and those with prior tuberculosis episodes are at even higher risk of disease recurrence. A non-sputum biomarker that identifies individuals at highest tuberculosis risk would allow targeted microbiological testing and appropriate treatment and also guide need for prolonged therapy. We determined the utility of a previously developed whole blood transcriptomic correlate of risk (COR) signature for (1) predicting incident recurrent tuberculosis, (2) tuberculosis diagnosis and (3) its potential utility for tuberculosis treatment monitoring in HIV-infected individuals. We retrieved cryopreserved blood specimens from three previously completed clinical studies and measured the COR signature by quantitative microfluidic real-time-PCR. The signature differentiated recurrent tuberculosis progressors from non-progressors within 3 months of diagnosis with an area under the Receiver-operating characteristic (ROC) curve (AUC) of 0.72 (95% confidence interval (CI), 0.58–0.85) amongst HIV-infected individuals on antiretroviral therapy (ART). Twenty-five of 43 progressors (58%) were asymptomatic at microbiological diagnosis and thus had subclinical disease. The signature showed excellent diagnostic discrimination between HIV-uninfected tuberculosis cases and controls (AUC 0.97; 95%CI 0.94–1). Performance was lower in HIV-infected individuals (AUC 0.83; 95%CI 0.81–0.96) and signature scores were directly associated with HIV viral loads. Tuberculosis treatment response in HIV-infected individuals on ART with a new recurrent tuberculosis diagnosis was also assessed. Signature scores decreased significantly during treatment. However, pre-treatment scores could not differentiate between those who became sputum negative before and after 2 months. Direct application of the unmodified blood transcriptomic COR signature detected subclinical and active tuberculosis by blind validation in HIV-infected individuals. However, prognostic performance for recurrent tuberculosis, and performance as diagnostic and as treatment monitoring tool in HIV-infected persons was inferior to published results from HIV-negative cohorts. Our results suggest that performance of transcriptomic signatures comprising interferon stimulated genes are negatively affected in HIV-infected individuals, especially in those with incompletely suppressed viral loads.

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“…The study included 402 patients from whom 344 patients were authorized to receive IPT, and 212 initiated IPT therapy. The implementation of IPT among patients with ART and TB was well tolerated, with a good percentage of completion and a smaller number of TB cases diagnosed after performing IPT [20].…”

Section: Resultsmentioning

confidence: 97%

Comparative analysis of the effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS treated with isoniazid

Juszkiewicz

Włoszczak-Szubzda

et al. 2019

Ann Agric Environ Med.

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Introduction. The epidemic of human immunodeficiency virus has had a tremendous effect on the epidemic of tuberculosis. Together with the spread of HIV, a great increase has been observed in morbidity due to tuberculosis, both in endemic countries and in those where earlier, as a result of treatment, the frequency of occurrence of tuberculosis had decreased. In 2018, the WHO data demonstrated that the EECA region was the only region worldwide where the epidemics of HIV was still rapidly increasing. The EECA region still struggles with a serious epidemic of tuberculosis. Materials and method. The research method applied was comparative analysis of the results of own study and studies by other researchers, concerning the effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS when treated with isoniazid. Results. In own study, it was found that primary morbidity among patients administered isoniazid significantly decreased within 5 years. Incidence rates of primary morbidity were significantly lower than among patients who had not received isoniazid. Relevant studies conducted worldwide, in many cases differed from own study with respect to both the results and approach to the problem, by country or selection of the type of patients participating in the study. However, in all studies, isoniazid was generally a safe and well-tolerated drug, without special side-effects. Conclusions. All studies analyzed concerning the effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS treated with isoniazid, confirmed the effectiveness of this drug. In the compared studies, applied isoniazid preventive therapy showed no difference in effectiveness according to its duration. Analyzed studies showed similar effectiveness also with respect to a decrease in mortality among patients with TB/HIV/AIDS.

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Implementing isoniazid preventive therapy in a tuberculosis treatment-experienced cohort on ART

Cited by 21 publications

References 27 publications

Implementation of isoniazid preventive therapy among people living with HIV in Northwestern Nigeria: Completion rate and predictive factors

Implementation of isoniazid preventive therapy among people living with HIV in Northwestern Nigeria: Completion rate and predictive factors

Detection of Tuberculosis Recurrence, Diagnosis and Treatment Response by a Blood Transcriptomic Risk Signature in HIV-Infected Persons on Antiretroviral Therapy

Comparative analysis of the effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS treated with isoniazid

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