Long-term effect of preventive therapy for tuberculosis in a cohort of HIV-infected Zambian adults

Quigley, Maria A.; Mwinga, Alwyn; Hosp, M; Lisse, Ida Maria; Fuchs, Dietmar; Jdh, Porter; Godfrey‐Faussett, Peter

doi:10.1097/00002030-200101260-00011

Cited by 118 publications

(90 citation statements)

References 15 publications

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“…[35][36][37][38] In the HIV pre-ART era, 6 months of IPT in high-transmission settings was durable for up to 18 months. [39,40] In the ART era, IPT has limited durability in high TB transmission settings. [40,41] In the Botswana trial of 6 v. 36 months of IPT, among persons who took 6 months of IPT the risk of TB increased approximately 200 days after stopping IPT, [31] while among persons who took 36 months of IPT, TB incidence increased by 90% after stopping IPT.…”

Section: Durability Of Iptmentioning

confidence: 99%

“…[39,40] In the ART era, IPT has limited durability in high TB transmission settings. [40,41] In the Botswana trial of 6 v. 36 months of IPT, among persons who took 6 months of IPT the risk of TB increased approximately 200 days after stopping IPT, [31] while among persons who took 36 months of IPT, TB incidence increased by 90% after stopping IPT. [42] Among SA goldminers, the incidence of TB in the intention-to-treat analysis was reduced by 58% during the intended 9-month IPT period.…”

Section: Durability Of Iptmentioning

confidence: 99%

“…[25] In the pre-ART era, however, the rifampicin-based regimens were shown to have a more durable effect than isoniazid alone. [40,41] A novel regimen of intermittent high-dose isoniazid and rifapentine given weekly for 3 months has recently been evaluated in low and high TB burden settings. Rifapentine is a rifamycin with a long half-life and greater potency against M. tuberculosis than rifampicin.…”

Section: Efficacy Of Alternative Preventive Therapy Regimensmentioning

confidence: 99%

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Tuberculosis preventive therapy: An underutilised strategy to reduce individual risk of TB and contribute to TB control

et al. 2014

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Section: Durability Of Iptmentioning

confidence: 99%

Section: Durability Of Iptmentioning

confidence: 99%

Section: Efficacy Of Alternative Preventive Therapy Regimensmentioning

confidence: 99%

See 1 more Smart Citation

Tuberculosis preventive therapy: An underutilised strategy to reduce individual risk of TB and contribute to TB control

et al. 2014

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“…However, in environments with a high prevalence of TB, preventive therapy against it for people infected with HIV offers protection against it although with no effect on HIV progression or mortality in cases where highly active antiretroviral therapy has not commenced [10,11]. In Nigeria, some AIDS treatment centers have reported HIV/TB coinfection [12,13].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of pulmonary tuberculosis (PTB) among people living with HIV/AIDS (PLWHA) in Keffi and its environs

2009

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Coinfection with HIV and Mycobacterium tuberculosis is known to be a lethal combination especially with its attendant mortality and morbidity. The need to have a baseline data in an environment like Keffi with a HIV/AIDS prevalence of 38.6% necessitated this study. Three hundred and ninety people living with HIV/AIDS (PLWHA) were screened for pulmonary tuberculosis. Results of this study showed 16.7% prevalence of coinfection in the population. Gender-related prevalence of coinfection was 19.4% and 14.4% among males and females respectively (P>0.05). Age-related prevalence of coinfection was least among respondents of age below 20 years (13.3%) and highest among those of age above 40 years (20.2%) (P>0.05). Even though statistically insignifi cant by both parameters, these fi ndings are of public health signifi cance. There is therefore an urgent need for immediate intervention to allow for early TB diagnosis, institution of anti-TB treatment and provision of prophylaxis against TB among TB-negative PLWHA.

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“…Two studies with longer follow-up in the pre-ART era show that TB rates return to those of the placebo arm 2 years after the initiation of IPT (39,40). Although active TB is prevented, the first IPT trial in HIV- infected adults was the only one to show a reduction in mortality (41).…”

Section: Preventionmentioning

confidence: 99%

Epidemiology of Tuberculosis and HIV: Recent Advances in Understanding and Responses

Martinson¹,

Hoffmann²,

Chaisson³

2011

Proceedings of the American Thoracic Society

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Although tuberculosis (TB) continues to cause enormous suffering and overwhelm health care systems in areas with high HIV prevalence, there have been a number of recent significant advances in knowledge regarding the epidemiology, management, and control of HIV-related TB. TB remains the most common serious opportunistic infection in people with HIV infection and the leading cause of death. However, there is some reason for optimism. First, two trials addressing when to start antiretroviral therapy (ART) in HIV-infected adults with newly diagnosed TB have shown that earlier initiation of ART reduces mortality significantly. Second, there is trial evidence of efficacy in giving long-term isoniazid preventive treatment (IPT) to HIV-infected adults in high HIV-prevalence settings where TB reinfection is frequent (much like cotrimoxazole). Third, the search for an inexpensive, rapid, sensitive, and specific TB diagnostic that is able to replace smear and delayed mycobacterial culture has yielded promising results. Responding to massive TB epidemics in high HIVprevalence settings, the World Health Organization has supplemented its directly observed treatment short-course strategy with one called the 3I's to actively screen and diagnose TB cases (intensified case finding), prevent new cases of TB with IPT, and prevent transmission of TB in congregate settings such as hospitals and clinics (infection control). Combating TB in high HIV-prevalence settings requires rapid and massive implementation of the 3I's with initiation of antiretrovirals and more effective efforts to prevent new HIV infections.

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Long-term effect of preventive therapy for tuberculosis in a cohort of HIV-infected Zambian adults

Abstract: Both PT regimens protect against tuberculosis for at least 2.5 years but appear to have no effect on HIV progression or mortality. These results may be used in cost-effectiveness models of PT.

Cited by 118 publications

References 15 publications

Tuberculosis preventive therapy: An underutilised strategy to reduce individual risk of TB and contribute to TB control

Tuberculosis preventive therapy: An underutilised strategy to reduce individual risk of TB and contribute to TB control

Prevalence of pulmonary tuberculosis (PTB) among people living with HIV/AIDS (PLWHA) in Keffi and its environs

Epidemiology of Tuberculosis and HIV: Recent Advances in Understanding and Responses

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