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Taking isoniazid preventive therapy for one year reduces the risk of TB in people taking antiretroviral therapy
Theo Smart, 2012-07-27 21:40:00
Twelve months of isoniazid (INH) preventive therapy (IPT) significantly reduced the incidence of all TB diagnoses among HIV-positive people who were taking concurrent antiretroviral therapy (ART) according to results of a large randomised study presented as a late breaker study on Thursday evening at the Nineteenth International AIDS Conference in Washington DC.
“There was a 37% reduction in the rate of incident TB in the INH treatment group compared to those who were receiving ART alone,” said Dr Molebogeng Xheedhe Rangaka of the University of Cape Town, who presented the study findings. Conversely, there was also suggestion of a higher risk of liver toxicity and no mortality benefit was observed.
Although the study wasn’t powered to answer the question, the protective effect of IPT didn’t seem to wear off very quickly in this context where ongoing TB transmission is believed to be exceedingly high. Although the protective effect of IPT seemed to be gradually lost over time, it did not wane as rapidly as has been reported in patients not on ART in the BOTUSA and THIBELA studies. This suggests that in patients on effective ART, IPT may not need to be given continuously to prevent TB, but could perhaps be taken intermittently, every second or third year.
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