对无家可归者中的潜伏性结核分枝杆菌感染者采用每周 1 次、共 12 次、直接观察的异烟肼和利福平治疗方案。
Treatment of latent Mycobacterium tuberculosis infection with 12 once weekly directly-observed doses of isoniazid and rifapentine among persons experiencing homelessness.
机构信息
ORISE Research Participation Program at Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
出版信息
PLoS One. 2019 Mar 13;14(3):e0213524. doi: 10.1371/journal.pone.0213524. eCollection 2019.
OBJECTIVES
To investigate treatment outcomes and associated characteristics of persons experiencing homelessness who received 12-weekly doses of directly observed isoniazid and rifapentine (3HP/DOT) treatment for latent TB infection (LTBI).
METHODS
Among homeless persons treated with 3HP/DOT during July 2011 -June 2015 in 11 U.S. TB programs, we conducted descriptive analyses of observational data, and identified associations between sociodemographic factors and treatment outcomes. Qualitative interviews were conducted to understand programmatic experiences.
RESULTS
Of 393 persons experiencing homelessness (median age: 50 years; range: 13-74 years), 301 (76.6%) completed treatment, 55 (14.0%) were lost to follow-up, 18 (4.6%) stopped because of an adverse event (AE), and 19 (4.8%) stopped after relocations or refusing treatment. Eighty-one (20.6%) had at least one AE. Persons aged ≥65 were more likely to discontinue treatment than persons aged 31-44 years. Programs reported difficulty in following up with persons experiencing homelessness because of relocations, mistrust, and alcohol or drug use.
CONCLUSIONS
This study demonstrates the feasibility of administering the 3HP/DOT LTBI regimen to persons experiencing homelessness, a high-risk population.
目的
调查接受每周一次直接观察异烟肼和利福平（3HP/DOT）治疗潜伏性结核感染（LTBI）的无家可归者的治疗结果和相关特征。
方法
在 2011 年 7 月至 2015 年 6 月期间，在 11 个美国结核病项目中接受 3HP/DOT 治疗的无家可归者中，我们对观察数据进行了描述性分析，并确定了社会人口因素与治疗结果之间的关联。进行了定性访谈以了解项目经验。
结果
在 393 名无家可归者（中位年龄：50 岁；范围：13-74 岁）中，301 名（76.6%）完成了治疗，55 名（14.0%）失访，18 名（4.6%）因不良反应（AE）而停止治疗，19 名（4.8%）因搬迁或拒绝治疗而停止治疗。81 人（20.6%）至少有一次 AE。≥65 岁的人与 31-44 岁的人相比，更有可能停止治疗。由于搬迁、不信任以及酒精或药物滥用，项目报告难以跟踪无家可归者。
结论
本研究证明了对无家可归者实施 3HP/DOT LTBI 方案的可行性，这是一个高风险人群。
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