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

• Published in: The international journal of tuberculosis and lung disease Vol. 21; no. 5; pp. 537 - 543
• Main Authors: Maharaj, B., Gengiah, T. N., Yende-Zuma, N., Gengiah, S., Naidoo, A., Naidoo, K.
• Format: Journal Article
• Language: English
• Published: France International Union Against Tuberculosis and Lung Disease 01.05.2017; International Union against Tuberculosis and Lung Disease (IUATLD)
• Subjects: Adult; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral therapy; Antitubercular Agents - administration & dosage; Antitubercular Agents - adverse effects; Cohort Studies; Data processing; Female; HIV; HIV Infections - drug therapy; Human Immunodeficiency Virus; Humans; Incidence; IPT; Isoniazid; Isoniazid - administration & dosage; Isoniazid - adverse effects; Latent Tuberculous Infection; Male; Medication Adherence; Patients; Prophylaxis; Prospective Studies; Secondary analysis; Sex Factors; Side effects; South Africa - epidemiology; Therapy; Tuberculosis; Tuberculosis - epidemiology; Tuberculosis - prevention & control; Viruses; South Africa
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.16.0775

SETTING: Urban clinical research site in Durban, South Africa.OBJECTIVE: To describe outcomes associated with the implementation of isoniazid preventive therapy (IPT) in a cohort of tuberculosis (TB) treatment-experienced human immunodeficiency virus (HIV) infected patients on antiretroviral therapy (ART).DESIGN: We conducted a secondary analysis of data collected between October 2009 and October 2013 from patients enrolled in a prospective cohort study conducted in Durban, South Africa.RESULTS: Of the 402 patients enrolled in the parent study, 344 (85.6%) were eligible for IPT, 212 of whom (61.6%) initiated IPT. Of those who initiated IPT, 184 (86.8%) completed the 6-month course, while 24 (11.3%) permanently discontinued IPT, 3.8% of whom due to side effects. More women than men initiated IPT (n = 130, 61.3% vs. n = 82, 38.7%, P = 0.001). Overall median adherence to IPT was 97.6% (interquartile range 94.2-99.4). There were 22 cases of incident TB in this cohort: 13 occurred before IPT and 9 after (incidence rate ratio 0.67, 95%CI 0.29-1.58, P = 0.362).CONCLUSIONS: IPT implementation among ART and TB treatment-experienced patients was well tolerated, with good completion rates and fewer TB cases diagnosed after IPT.