Isoniazid Preventive Therapy in Contacts of Multidrug-resistant Tuberculosis.

Huang, Chuan-Chin; Galea, Jerome; Calderon, Roger; Grandjean, Louis; Yataco, Rosa; Becerra, Mercedes C.; Contreras, Carmen; Zhang, Zibiao; Lecca, Leonid; Murray, Megan

dc.contributor.author	Huang, Chuan-Chin
dc.contributor.author	Becerra, Mercedes C.
dc.contributor.author	Calderon, Roger
dc.contributor.author	Contreras, Carmen
dc.contributor.author	Galea, Jerome
dc.contributor.author	Grandjean, Louis
dc.contributor.author	Lecca, Leonid
dc.contributor.author	Yataco, Rosa
dc.contributor.author	Zhang, Zibiao
dc.contributor.author	Murray, Megan
dc.date.accessioned	2020-07-14T00:01:17Z
dc.date.available	2020-07-14T00:01:17Z
dc.date.issued	2020
dc.identifier.uri	https://hdl.handle.net/20.500.12866/8308
dc.description.abstract	RATIONALE: The World Health Organization recommends the use of isoniazid alone or in combination with rifapentine to treat latent tuberculosis infection. The recent rise of drug-resistant tuberculosis has complicated the choice of latent tuberculosis infection treatment regimen. OBJECTIVES: To evaluate the effects of isoniazid preventive therapy on contacts of multidrug-resistant tuberculosis patients Methods: In a prospective cohort study conducted between September 2009 and August 2012, we identified 4,500 index tuberculosis patients and 14,044 tuberculosis-exposed household contacts whom we followed for one year for the occurrence of incident tuberculosis disease. Although Peruvian national guidelines specify that isoniazid preventive therapy should be provided to contacts aged 19 and under, only half this group received isoniazid preventive therapy. MEASUREMENTS AND MAIN RESULTS: Among 4,216 contacts under 19 years of age, 2,106 (50%) initiated isoniazid preventive therapy at enrollment. The protective effect of isoniazid was more extreme in contacts exposed to drug-sensitive (adjusted hazard ratio, 0.30 [95% confidence interval, 0.18-0.48]) and to multidrug-resistant tuberculosis (0.19 [0.05-0.66]) compared to those exposed to mono-isoniazid-resistant (0.80 [0.23-2.80]). In the second independent study, tuberculosis occurred in none of the 76 household contacts who received isoniazid preventive therapy compared to 3% (8/273) of those who did not. CONCLUSION: Household contacts who received isoniazid preventive therapy had a lower incidence of tuberculosis disease even when they had been exposed to an index patient with multidrug-resistant tuberculosis. Isoniazid may have a role in the management of latent multidrug-resistant tuberculosis infection.	en_US
dc.language.iso	eng
dc.publisher	American Thoracic Society
dc.relation.ispartofseries	American Journal of Respiratory and Critical Care Medicine
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	tuberculosis	en_US
dc.subject	isoniazid	en_US
dc.subject	isoniazid preventive therapy	en_US
dc.subject	multidrug-resistant tuberculosis	en_US
dc.title	Isoniazid Preventive Therapy in Contacts of Multidrug-resistant Tuberculosis.	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1164/rccm.201908-1576OC
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.02.07
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.02.08
dc.relation.issn	1535-4970