2nd National Conference Human Retroviruses and Related Infections Washington, DC - January 29 - February 2, 1995

Natl Conf Hum Retrovir Relat Infect 1995 Jan 29-Feb 2;2: (abstract no. 5)

Halsey N, Coberly J, Losikoff P, Atkinson J, Moulton L, Cantave M, Johnson M, Chaisson R, Geiter L, Huebner R
CDS, Port-au-Prince, Haiti; Johns Hopkins University, Baltimore, Maryland; and CDC, Atlanta, Georgia

OBJECTIVE: To compare the effectiveness of 2 regimens for prevention of tuberculosis (TB) in HIV seropositive, PPD positive adults.

METHODS: Haitian adults were screened for HIV, active pulmonary disease and evidence of past infection with M. tuberculosis. 784 adults were randomized to receive isoniazid (INH) for 6 months or rifampin and pyrazinamide (R&P) twice weekly for 2 months. TB was defined as a positive culture, smear, biopsy, or response to therapy.

RESULTS: The Kaplan-Meier estimate of the risk of TB during the first 10 months after randomization was 3.5% for the R&D group vs.8% for the INH group (hazard rate ratio=8.4, p=0.01). No significant differences in the rates of TB were observed after 10 months when neither group was taking drugs. No TB was detected in either group during the first three months after randomization.

CONCLUSIONS: Twice weekly INH chemoprophylaxis for 6 months provides effective prevention against TB in HIV infected adults during the treatment period, but the optimal duration of prophylaxis has not been determined. The differences in the rates of breakthrough TB appear to be related primarily to the different durations of prophylaxis.

Keywords: AIDS Vaccines, Acquired Immunodeficiency Syndrome, Adult, HIV Infections, HIV Seropositivity, Haiti, Humans, Infection, Isoniazid, Pyrazinamide, Rifampin, Tuberculin Test, Tuberculosis, therapy

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1995-01-29
5

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