Three months of weekly rifapentine plus isoniazid for latent tuberculosis treatment in solid organ transplant candidates

Abstract

Directly observed 3HP LTBI treatment was not associated with hepatotoxicity, even in patients with higher MELD scores. Further studies are needed to confirm the safety and efficacy of this LTBI treatment regimen in the SOT population.

Treatment of latent TB Infection and the risk of tuberculosis after solid organ transplantation: Comprehensive review

“…Our extensive review of the literature identified four other detailed case reports that documented the development of active TB disease after LTBI treatment . In addition, we found a total of 56/2651 (2.1%) cases of active TB among 41 observational cohorts and six RCT . Among them, only five cases were described in detail.…”

“…We found 41 cohort studies that evaluated the outcome of LTBI therapy. Eleven were from Europe, 10 from US and Asia, seven from South America, and one each from Africa, Australia, and Canada . Only nine were prospective .…”

“…Eleven were from Europe, 10 from US and Asia, seven from South America, and one each from Africa, Australia, and Canada . Only nine were prospective . Most studies included kidney (22) and liver (12) transplant recipients only.…”

“…Most studies included kidney (22) and liver (12) transplant recipients only. There were three studies on lung and four on multiple organ transplants . The decision to start LTBI therapy was based on clinician preference, universal prophylaxis or the presence of risk factors (22/39) including past history of treated or untreated TB, close exposure to a person with active TB, evidence of TB on imaging, reactive or anergic response to TST or a positive Interferon based Gamma Release Assay (IGRA) response.…”

“…The indication was not specified in two studies . Fifteen studies initiated prophylaxis based on TST or IGRA responses alone. INH prophylaxis was the preferred regimen in all studies except one, which used a combination of levofloxacin and ethambutol .…”