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对艾滋病毒感染者采用每周一次利福喷丁加异烟肼的方案进行三个月的结核病预防治疗。

Three months of weekly rifapentine plus isoniazid for TB prevention among people with HIV.

作者信息

Borse R, Randive B, Mattoo S, Malik P, Solanki H, Gupta A, Chaisson R E, Mave V, Suryavanshi N

机构信息

Byramjee Jeejeebhoy Government Medical College, Pune, India.

Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India.

出版信息

IJTLD Open. 2024 Sep 1;1(9):404-409. doi: 10.5588/ijtldopen.23.0609. eCollection 2024 Sep.

Abstract

BACKGROUND

Evidence on implementation of three months of weekly isoniazid (H, INH) and rifapentine (P, RPT) (3HP) as a TB preventive therapy (TPT) for at-risk groups in Indian programmatic conditions is limited.

METHODS

A prospective demonstration study assessing scale-up, safety, and effectiveness of 3HP TPT among people living with HIV (PLHIV) in Indian programmatic settings was conducted.

RESULTS

Of 656 screened PLHIV, 502 (77%) received 3HP. Of these, 20 (4%) discontinued TPT due to toxicity,17 (3.8%) lost to follow-up, one (0.2%) had breakthrough rifampicin-sensitive TB, and 464 (92%) completed 3 HP TPT. Of 288 (57%) overall adverse events (AEs), 46 (9%) had Grade 2 or above AEs. The median time to AE was 14 days (IQR 7-42). Serious adverse events (SAEs) were reported in 9 (2%) participants; of these, 7 (78%) were not related to 3HP. No TB episodes occurred during the 1-year follow-up period.

CONCLUSION

3HP TPT completion rate of 92%, with few adverse events leading to 3HP discontinuation, providing evidence of the scalability and safety of 3HP TPT among PLHIV in Indian health program settings.

摘要

背景

在印度的项目实施条件下,关于将三个月每周一次的异烟肼(H,INH)和利福喷汀(P,RPT)(3HP)作为高危人群结核病预防治疗(TPT)的实施证据有限。

方法

开展了一项前瞻性示范研究,评估印度项目环境中HIV感染者(PLHIV)接受3HP TPT的扩大规模、安全性和有效性。

结果

在656名接受筛查的PLHIV中,502名(77%)接受了3HP治疗。其中,20名(4%)因毒性反应停止TPT治疗,17名(3.8%)失访,1名(0.2%)发生利福平敏感结核病突破,464名(92%)完成了3HP TPT治疗。在288例(57%)总体不良事件(AE)中,46例(9%)发生2级或以上AE。AE发生的中位时间为14天(IQR 7 - 42)。9名(2%)参与者报告了严重不良事件(SAE);其中,7名(78%)与3HP无关。在1年随访期内未发生结核病发作。

结论

3HP TPT完成率为92%,因不良事件导致3HP停药的情况很少,这为印度卫生项目环境中PLHIV接受3HP TPT的可扩展性和安全性提供了证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e23/11409171/7c7005676963/ijtldopen24-0609f1.jpg

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