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Review
. 2019 Dec 31;188(12):2078-2085.
doi: 10.1093/aje/kwz172.

Seventy Years of Tuberculosis Prevention: Efficacy, Effectiveness, Toxicity, Durability, and Duration

Nicole Salazar-Austin, David W Dowdy, Richard E Chaisson, Jonathan E Golub
Review

Seventy Years of Tuberculosis Prevention: Efficacy, Effectiveness, Toxicity, Durability, and Duration

Nicole Salazar-Austin et al. Am J Epidemiol. .

Abstract

Tuberculosis (TB) has been a leading infectious cause of death worldwide for much of human history, with 1.6 million deaths estimated in 2017. The Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health has played an important role in understanding and responding to TB, and it has made particularly substantial contributions to prevention of TB with chemoprophylaxis. TB preventive therapy is highly efficacious in the prevention of TB disease, yet it remains underutilized by TB programs worldwide despite strong evidence to support its use in high-risk groups, such as people living with HIV and household contacts, including those under 5 years of age. We review the evidence for TB preventive therapy and discuss the future of TB prevention.

Keywords: TB preventive therapy (TPT); prevention; tuberculosis.

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Figures

Figure 1.
Figure 1.
A history of tuberculosis preventive therapy (TPT). 18H, 12H, 9H, and 6H refer to 18, 12, 9, and 6 months of daily isoniazid, respectively, and 3R and 4R refer to 3 and 4 months of daily rifampin, respectively. 1HP, 1 month of daily rifapentine and isoniazid; 3HP, 3 months of weekly rifapentine and isoniazid; 3HR, 3 months of daily isoniazid and rifampin; 3RZ, 3 months of daily rifampin and pyrazinamide; IPT, isoniazid preventive therapy; LTBI, latent tuberculosis infection; PLHIV, people living with human immunodeficiency virus; TB, tuberculosis; WHO, World Health Organization.
Figure 2.
Figure 2.
Duration of tuberculosis preventive therapy over time, as recommended by the American Thoracic Society. Abbreviations: 1HP, 1 month of daily rifapentine and isoniazid; 3HP, 3 months of weekly rifapentine and isoniazid.
See this image and copyright information in PMC

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