Long-Term Protective Effect of Tuberculosis Preventive Therapy in a Medium/High Tuberculosis Incidence Setting
Long-Term Protective Effect of Tuberculosis Preventive Therapy in a Medium/High Tuberculosis Incidence Setting
Data
2024
Autores
Teixeira, Leidy Anne Alves
Santos, Braulio
Correia, Marcelo Goulart
Valiquette, Chantal
Bastos, Mayara Lisboa
Menzies, Dick
Trajman, Anete
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical Infectious Diseases
Resumo
The duration of the protective effect of tuberculosis preventive therapy (TPT) is controversial. Some studies have
found that the protective effect of TPT is lost after cessation of therapy among people with human immunodeficiency virus (HIV) in
settings with very high tuberculosis incidence, but others have found long-term protection in low-incidence settings.
Methods. We estimated the incidence rate (IR) of new tuberculosis disease for up to 12 years after randomization to 4 months of
rifampin or 9 months of isoniazid, among 991 Brazilian participants in a TPT trial in the state of Rio de Janeiro, with an incidence of
68.6/100 000 population in 2022. The adjusted hazard ratios (aHRs) of independent variables for incident tuberculosis were calculated.
Results. The overall tuberculosis IR was 1.7 (95% confidence interval [CI], 1.01– 2.7) per 1000 person-years (PY). The tuberculosis
IR was higher among those who did not complete TPT than in those who did (2.9 [95% CI, 1.3–5.6] vs 1.1 [.4–2.3] per 1000 PY; IR
ratio, 2.7 [1.0–7.2]). The tuberculosis IR was higher within 28 months after randomization (IR, 3.5 [95% CI, 1.6–6.6] vs 1.1 [.5–2.1] per
1000 PY between 28 and 143 months; IR ratio, 3.1 [1.2–8.2]). Treatment noncompletion was the only variable associated with incident
tuberculosis (aHR, 3.2 [95% CI, 1.1–9.7]).
Conclusions. In a mostly HIV-noninfected population, a complete course of TPT conferred long-term protection against
tuberculosis.
Description
Palavras-chave
Mycobacterium tuberculosis, isoniazid, rifampicin, Brazil, latent tuberculosis infection.
Citação
Teixeira LAA, Santos B, Correia MG, Valiquette C, Bastos ML, Menzies D, Trajman A. Long-Term Protective Effect of Tuberculosis Preventive Therapy in a Medium/High Tuberculosis Incidence Setting. Clin Infect Dis. 2024 May 15;78(5):1321-1327. doi: 10.1093/cid/ciae101.