Safety and Efficacy of Rifampin or Isoniazid Among People With Mycobacterium tuberculosis Infection and Living With Human Immunodeficiency Virus or Other Health Conditions: Post Hoc Analysis of 2 Randomized Trials
Safety and Efficacy of Rifampin or Isoniazid Among People With Mycobacterium tuberculosis Infection and Living With Human Immunodeficiency Virus or Other Health Conditions: Post Hoc Analysis of 2 Randomized Trials
Data
2021
Autores
Campbell, Jonathon R.
Al-Jahdali, Hamdan
Bah, Boubacar
Belo, Marcia
Cook, Victoria J.
Long, Richard
Schwartzman, Kevin
Trajman, Anete
Menzies, Dick
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical Infectious Diseases
Resumo
Background. The safety and efficacy of rifampin among people living with human immunodeficiency virus (PLHIV) or other
health conditions is uncertain. We assessed completion, safety, and efficacy of 4 months of rifampin vs 9 months of isoniazid among
PLHIV or other health conditions.
Methods. We conducted post hoc analysis of 2 randomized trials that included 6859 adult participants with Mycobacterium
tuberculosis infection. Participants were randomized 1:1 to 10 mg/kg/d rifampin or 5 mg/kg/d isoniazid. We report completion,
drug-related adverse events (AE), and active tuberculosis incidence among people living with HIV; with renal failure or receiving
immunosuppressants; using drugs or with hepatitis; with diabetes mellitus; consuming >1 alcoholic drink per week or current/
former smokers; and with no health condition.
Results. Overall, 270 (3.9%) people were living with HIV (135 receiving antiretroviral therapy), 2012 (29.3%) had another health
condition, and 4577 (66.8%) had no condition. Rifampin was more often or similarly completed to isoniazid in all populations. AEs
were less common with rifampin than isoniazid among PLHIV (risk difference, −2.1%; 95% confidence interval [CI], −5.9 to 1.6).
This was consistent for others except people with renal failure or on immunosuppressants (2.1%; 95% CI, −7.2 to 11.3). Tuberculosis
incidence was similar among people receiving rifampin or isoniazid. Among participants receiving rifampin living with HIV, inci-
dence was comparable to those with no health condition (rate difference, 4.1 per 1000 person-years; 95% CI, −6.4 to 14.7).
Conclusions. Rifampin appears to be safe and as effective as isoniazid across many populations with health conditions, including
HIV.
Clinical Trials Registration. NCT00170209; NCT00931736.
Description
Palavras-chave
tuberculosis, comorbidity, HIV, patient-centered care, rifampin.
Citação
Campbell JR, Al-Jahdali H, Bah B, Belo M, Cook VJ, Long R, Schwartzman K, Trajman A, Menzies D. Safety and Efficacy of Rifampin or Isoniazid Among People With Mycobacterium tuberculosis Infection and Living With Human Immunodeficiency Virus or Other Health Conditions: Post Hoc Analysis of 2 Randomized Trials. Clin Infect Dis. 2021 Nov 2;73(9):e3545-e3554. doi: 10.1093/cid/ciaa1169.