Prophylaxis for tuberculosis in Europe--ongoing research.
The incidence of tuberculosis (TB) in patients with human immunodeficiency virus (HIV) infection has increased in recent years, raising issues regarding preventive therapy for TB in this high-risk patient population. To determine if an HIV-positive individual is at risk for reactivation of latent infection, testing with purified protein derivative (PPD) is recommended; however, many people with impaired cell-mediated immunity due to HIV are anergic. Strategies regarding PPD testing and criteria for HIV-positive patients are presented. Isoniazid has been the accepted drug for use as prophylaxis for TB in immunocompetent patients, and there is evidence that isoniazid is also effective in HIV-positive, PPD-positive patients. Data from efficacy and feasibility trials and the risks and benefits of preventive therapy with isoniazid are discussed. Because of toxicity and compliance problems with isoniazid, there is a continuing need for development of alternative therapies. The results of some preliminary studies of newer therapies are presented here.
Carosi
G
G
Clinic of Infectious and Tropical Diseases, University of Brescia, Italy.
Matteelli
A
A
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control*; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D005060:Europe; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D012294:Rifamycins / Q000627:therapeutic use; D014376:Tuberculosis / Q000517:prevention & control*
D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D012294:Rifamycins; D007538:Isoniazid