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. 2017 May 1;21(5):537-543.
doi: 10.5588/ijtld.16.0775.

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

B Maharaj  1 , T N Gengiah  1 , N Yende-Zuma  1 , S Gengiah  1 , A Naidoo  1 , K Naidoo  2
Affiliations

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

B Maharaj et al. Int J Tuberc Lung Dis. .

Abstract

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.

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Conflict of interest statement

Conflict of Interest

All authors report no conflict of interests.

Figures

Figure 1
Figure 1
IPT uptake and course outcomes
Figure 2
Figure 2
Adherence to IPT by monthly pill count
Figure 3
Figure 3
Liver function indicators in IPT users taken within a window 3 months prior to IPT initiation. Panel (A) is AST and panel (B) is ALT.
See this image and copyright information in PMC

References

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    1. South African Department of Health. National Consolidated Guidelines for the Prevention of Mother-To-Child Transmission Of HIV (PMTCT) and the management of HIV in children, adolescents and adults. Pretoria, South Africa: DOH; 2015.
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