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Isoniazid Preventive Therapy in Contacts of Multidrug-resistant Tuberculosis.

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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.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
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


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