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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Annual Tuberculosis Preventive Therapy for Persons with HIV Infection
Annals of Internal Medicine, Volume 174, No. 10, Year 2021
Notification
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Description
Background: Tuberculosis preventive therapy for persons with HIV infection is effective, but its durability is uncertain. Objective: To compare treatment completion rates of weekly isoniazid–rifapentine for 3 months versus daily isoniazid for 6 months as well as the effectiveness of the 3-month rifapentine–isoniazid regimen given annually for 2 years versus once. Design: Randomized trial. (ClinicalTrials.gov: NCT02980016) Setting: South Africa, Ethiopia, and Mozambique. Participants: Persons with HIV infection who were receiving antiretroviral therapy, were aged 2 years or older, and did not have active tuberculosis. Intervention: Participants were randomly assigned to receive weekly rifapentine–isoniazid for 3 months, given either annually for 2 years or once, or daily isoniazid for 6 months. Participants were screened for tuberculosis symptoms at months 0 to 3 and 12 of each study year and at months 12 and 24 using chest radiography and sputum culture. Measurements: Treatment completion was assessed using pill counts. Tuberculosis incidence was measured over 24 months. Results: Between November 2016 and November 2017, 4027 participants were enrolled; 4014 were included in the analyses (median age, 41 years; 69.5% women; all using antiretroviral therapy). Treatment completion in the first year for the combined rifapentine–isoniazid groups (n = 3610) was 90.4% versus 50.5% for the isoniazid group (n = 404) (risk ratio, 1.78 [95% CI, 1.61 to 1.95]). Tuberculosis incidence among participants receiving the rifapentine–isoniazid regimen twice (n = 1808) or once (n = 1802) was similar (hazard ratio, 0.96 [CI, 0.61 to 1.50]). Limitation: If rifapentine–isoniazid is effective in curing subclinical tuberculosis, then the intensive tuberculosis screening at month 12 may have reduced its effectiveness. Conclusion: Treatment completion was higher with rifapentine–isoniazid for 3 months compared with isoniazid for 6 months. In settings with high tuberculosis transmission, a second round of preventive therapy did not provide additional benefit to persons receiving antiretroviral therapy. © 2021 American College of Physicians. All rights reserved.
Authors & Co-Authors
Churchyard, Gavin John
South Africa, Johannesburg
The Aurum Institute
Cárdenas, Vicky
Unknown Affiliation
Chihota, Violet N.
South Africa, Johannesburg
The Aurum Institute
Mngadi, Kathryn Therese
South Africa, Johannesburg
Tembisa Provincial Tertiary Hospital
Sebe, Modulakgotla A.
South Africa, Johannesburg
Tembisa Provincial Tertiary Hospital
Brumskine, William
South Africa, Johannesburg
The Aurum Institute
Martinson, Neil Alexander
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Yimer, Getnet
Unknown Affiliation
Wang, Shuhua
Unknown Affiliation
García-Basteiro, Alberto L.
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Nguenha, Dinis
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Masilela, Lee Anne
South Africa, Johannesburg
The Aurum Institute
Waggie, Zainab
Unknown Affiliation
van den Hof, Susan
Netherlands, Bilthoven
Rijksinstituut Voor Volksgezondheid en Milieu
Charalambous, Salome
South Africa, Johannesburg
The Aurum Institute
Cobelens, Frank G.J.
Netherlands, Amsterdam
Amsterdam Institute for Global Health and Development
Chaisson, Richard E.
United States, Baltimore
Johns Hopkins University
Grant, Alison D.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Fielding, Katherine L.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Churchyard, Gavin
Unknown Affiliation
Yates, Sarah
Unknown Affiliation
Sikula, Jabulani
Unknown Affiliation
Naicker, Samantha
Unknown Affiliation
McHunu, Lihle
Unknown Affiliation
Mlokoti-Fikeni, Zonke
Unknown Affiliation
Ndebele, Felex
Unknown Affiliation
Makkan, Heeran
Unknown Affiliation
Ndlovu, Nontobeko T.
Unknown Affiliation
Mpahlele, Phillip
Unknown Affiliation
Mokone, Nontobeko
Unknown Affiliation
Mngomezulu, Lerato
Unknown Affiliation
Seatlanyane, Pule
Unknown Affiliation
Senne, Melissa Neo
Unknown Affiliation
Khumalo, Siyethemba
Unknown Affiliation
Munedzimwe, Fadzai
Unknown Affiliation
Muthelo, Azwi
Unknown Affiliation
Mbonisa, Fezeka
Unknown Affiliation
Masia, Lebogang
Unknown Affiliation
Shibambo, Kgaugelo
Unknown Affiliation
Mudzengi, Don L.
Unknown Affiliation
Fielding, Katherine Linda
United Kingdom, London
London School of Hygiene & Tropical Medicine
Grant, Alison D.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Vassall, Anna
United Kingdom, London
London School of Hygiene & Tropical Medicine
Bozzani, Fiammetta Maria
United Kingdom, London
London School of Hygiene & Tropical Medicine
Moloantoa, Tumelo
Unknown Affiliation
Yende, Nompumelelo
Unknown Affiliation
Letoba, Gabriel
Unknown Affiliation
Holele, Itumeleng
Unknown Affiliation
Wang, Shuhua
Unknown Affiliation
Bekele, Achenef
Unknown Affiliation
Lisanwork, Leuel
Unknown Affiliation
Shewaamare, Aster
Unknown Affiliation
Atsebeha, Miruts
Unknown Affiliation
Solomon, Haymet
Unknown Affiliation
Hagezoh, Dagnew
Unknown Affiliation
Weji, Mulugeta
Unknown Affiliation
Kebede, Ketema
Unknown Affiliation
Mengesha, Desalegne
Unknown Affiliation
Biluts, Hagos
Unknown Affiliation
Kidane, Achenef
Unknown Affiliation
Bisrat, Haileleuel
Unknown Affiliation
Berta, Oumer
Unknown Affiliation
Zeberga, Genet
Unknown Affiliation
Mengesha, Helen
Unknown Affiliation
Minwuyelet, Tewodros
Unknown Affiliation
Shewarega, Azeb
Unknown Affiliation
Siyum, Woyneshet
Unknown Affiliation
Hussen, Rihana
Unknown Affiliation
Kebede, Abinet
Unknown Affiliation
Endashaw, Tigist
Unknown Affiliation
Tanka, Yemeserach
Unknown Affiliation
Gebreyes, Wondwossen Abebe
Unknown Affiliation
Saavedra, Belén
Unknown Affiliation
Mambique, Edson
Unknown Affiliation
Ampuero, David
Unknown Affiliation
Izco, Santiago
Unknown Affiliation
Cossa, Joaquim
Unknown Affiliation
Sterling, Timothy R.
Unknown Affiliation
Chakaya, Jeremiah Muhwa
Unknown Affiliation
von Delft, Darlene
Unknown Affiliation
Hughes, Michael D.
Unknown Affiliation
Maartens, Gary Tuberculosis
Unknown Affiliation
Nunes, Elizabete Abrantes
Unknown Affiliation
Woldeamanuel, Yimtubezinash
Unknown Affiliation
Statistics
Citations: 18
Authors: 84
Affiliations: 8
Identifiers
Doi:
10.7326/M20-7577
ISSN:
00034819
Research Areas
Environmental
Infectious Diseases
Study Design
Randomised Control Trial
Cohort Study
Study Locations
Ethiopia
Mozambique
South Africa
Participants Gender
Female