Kinikar A, Borse R, Randive B, Kamath P, Mattoo S K, Parmar M, Solanki H, Mave V, Gupta A, Chaisson R E, Suryavanshi N
Byramjee Jeejeebhoy Government Medical College (BJGMC), Pune, India.
BJGMC-Johns Hopkins University Clinical Research Site, Pune, India.
IJTLD Open. 2024 Sep 1;1(9):413-417. doi: 10.5588/ijtldopen.24.0305. eCollection 2024 Sep.
India's National TB Elimination Programme plans to roll out short-course TB preventive therapy (TPT) using 3 months of rifapentine and isoniazid (3HP). Understanding the feasibility and safety of children in programmatic settings is critical for widespread implementation. We present the findings of a targeted scale-up of 3HP among children and adolescents living with HIV (CALHIV) and child household contacts (>2 to <6 years) of pulmonary TB patients (CHHC).
Between December 2021 and July 2023, eligible CALHIV and CHHC participants were given weekly dosages of 3HP for 3 months at antiretroviral therapy (ART) and TB clinics, respectively, of a public hospital in Pune, India.
Of 97 children screened, 91 initiated 3HP (32 CALHIV and 59 CHHC). The median age of CALHIV was 14 years; 66% were male and on dolutegravir-based ART. The median age of CHHC was 4 years; 47% were males. Thirty-one (97%) CALHIV and 56 (95%) CHHC completed 3HP without dolutegravir dose adjustment. None of the child participants discontinued 3HP due to adverse events. No child participant developed TB during 1 year of follow-up post-3HP.
Our study provides evidence of the uptake and feasibility of the planned nationwide rollout of 3HP.
印度国家结核病消除计划计划推广使用3个月利福喷汀和异烟肼（3HP）的短程结核病预防性治疗（TPT）。了解在项目环境中儿童使用该疗法的可行性和安全性对于广泛实施至关重要。我们展示了在感染艾滋病毒的儿童和青少年（CALHIV）以及肺结核患者的儿童家庭接触者（>2至<6岁，CHHC）中针对性扩大3HP使用规模的研究结果。
2021年12月至2023年7月期间，符合条件的CALHIV和CHHC参与者分别在印度浦那一家公立医院的抗逆转录病毒治疗（ART）诊所和结核病诊所接受为期3个月的每周一次3HP剂量治疗。
在97名接受筛查的儿童中，91名开始使用3HP（32名CALHIV和59名CHHC）。CALHIV的中位年龄为14岁；66%为男性，接受基于多替拉韦的ART治疗。CHHC的中位年龄为4岁；47%为男性。31名（97%）CALHIV和56名（95%）CHHC在未调整多替拉韦剂量的情况下完成了3HP治疗。没有儿童参与者因不良事件而停用3HP。在3HP治疗后的1年随访期间，没有儿童参与者患结核病。
我们的研究为计划在全国范围内推广3HP的接受度和可行性提供了证据。
