Isoniazid preventive therapy in HIV-infected children on antiretroviral therapy: a pilot study

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
Diane M GrayH J Zar

Abstract

Tuberculosis (TB) is a common cause of mortality and morbidity in children infected with the human immunodeficiency virus (HIV). Data on isoniazid preventive therapy (IPT) efficacy in HIV-infected children receiving antiretroviral therapy (ART) are inconclusive. To assess the efficacy, tolerability and safety of isoniazid (INH) in HIV-infected children on ART. A pilot randomised controlled study of INH was undertaken in HIV-infected children on ART. The primary outcome measure was TB disease or death. A total of 167 children were randomised to receive INH (n = 85) or placebo (n = 82), and followed for a median of 34 months (interquartile range [IQR] 24-52). The median age was 35 months (IQR 15-65). There was one death in a child on INH and none in the placebo group. Eleven (6.6%) cases of TB occurred, 4 (5%) in the INH and 7 (9%) in the placebo group. Among the TB cases, 5 were culture confirmed-2 in the INH group and 3 in the placebo group, all susceptible to INH. Severe adverse events occurred rarely (n = 6; 2%). IPT is safe and well tolerated in HIV-infected children on concomitant ART. This study supports the need for a larger study to assess efficacy in HIV-infected children living in TB-endemic areas.

Citations

Dec 28, 2017·The Pediatric Infectious Disease Journal·Jaykaran CharanAmbuj Kumar
Nov 9, 2018·Current Opinion in HIV and AIDS·Justine FargherJennifer Furin
Aug 30, 2017·The Cochrane Database of Systematic Reviews·Moleen ZunzaH J Zar
Feb 14, 2020·MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports·Timothy R SterlingRobert Belknap
Jun 22, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sylvia M LaCourseGrace John-Stewart
Mar 30, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Timothy R SterlingRobert Belknap
Oct 9, 2020·BMC Infectious Diseases·Olivia F HunterLisa V Adams

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