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A randomized trial of 2 months of rifampin (RIF) and pyrazinamide (PZA) versus 12 months of isoniazid (INH) for the prevention of tuberculosis (TB) in HIV-positive (+), PPD+ patients (pts).

Gordin F, Chaisson R, Matts J, Miller C, Garcia L, Hafner R, O'Brien R; Conference on Retroviruses and Opportunistic Infections.

Program Abstr 5th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 5th 1998 Chic Ill. 1998 Feb 1-5; 5th: 223 (abstract no. LB5).

VA Medical Center, Washington, DC.

The effectiveness of the recommended 12-month INH regimen for prevention of TB in pts co-infected with HIV and TB is limited by poor compliance. Objective: To determine the effectiveness of an alternative, short-course RIF-based regimen by comparison of safety and efficacy with standard INH prophylaxis. Methods: Randomized trial in HIV+ adults with documented greater than or equal to 5 mm PPD. Pts were treated with daily INH (300mg) for 12 mos or daily RIF (600mg) + PZA (20mg/kg) for 2 mos. Results: From Sept 91 to May 96, 1583 HIV+ pts enrolled from the United States (1128), Mexico (181), Haiti (157) and Brazil (117). All pts had a documented past (43%) or current (57%) + PPD. The mean age was 37; 72% were male; 51% African American or Haitian, 35% Latino, and 11% White. The mean CD4 count was 485, and only 7% had a history of an AIDS -defining event at entry. With a mean follow-up of 36 mos, the preliminary results are: (Table: see text) Both regimens had similar event rates in all demographic groups and countries. Adverse events were reported for 10.7% of pts on INH and 12.5% on RIF+PZA (p=0.27). Overall, 68% of pts on INH completed therapy vs. 80% on RIF+PZA (p less than .001). Conclusion: 2 months of RIF+PZA is a safe and effective regimen for the prevention of TB and offers programmatic advantages over 12 months of INH.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Acquired Immunodeficiency Syndrome
  • Adult
  • Brazil
  • Clinical Protocols
  • Clinical Trials as Topic
  • HIV Infections
  • HIV Seropositivity
  • Haiti
  • Humans
  • Isoniazid
  • Male
  • Mexico
  • Patient Compliance
  • Pyrazinamide
  • Rifampin
  • Tuberculin
  • Tuberculin Test
  • Tuberculosis
  • United States
  • immunology
  • methods
  • therapy
Other ID:
  • 98929695
UI: 102236348

From Meeting Abstracts




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