Tolerability of twice-weekly rifabutin-isoniazid combinations versus daily isoniazid for latent tuberculosis in HIV-infected subjects: a pilot study.
The tolerability of and adherence to intermittent short-term rifabutin-isoniazid preventive treatment was assessed in subjects dually infected with Mycobacterium tuberculosis and the human immunodeficiency virus (HIV). In a randomised, open-label, phase II pilot study, 44 subjects received either rifabutin 300 mg and isoniazid 750 mg twice weekly for 3 months (group A, n = 16) or the same regimen with rifabutin at 600 mg (group B, n = 14), or isoniazid 300 mg/day for 6 months (group C, n = 14). Three, two and four subjects in groups A, B, and C, respectively, did not complete their treatment (one case of flu-like syndrome in group B; one methadone withdrawal syndrome in group A; and patient decision in two cases in group A and four in group C). Overall, adverse events were reported by four, nine, and seven subjects in groups A, B and C, respectively. Intermittent combined rifabutin + isoniazid for 3 months had lower default rates than daily standard isoniazid for 6 months. The regimen with rifabutin at 300 mg dose compared favourably to standard isoniazid, and warrants larger efficacy studies to assess its role for the prevention of latent tuberculosis in HIV-infected subjects.
Matteelli
A
A
Clinic of Infectious and Tropical Diseases, University of Brescia, Italy. forleo@master.cci.unibs.it
Olliaro
P
P
Signorini
L
L
Cadeo
G
G
Scalzini
A
A
Bonazzi
L
L
Caligaris
S
S
Tomasoni
L
L
Tebaldi
A
A
Carosi
G
G
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage*; D000995:Antitubercular Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage*; D010865:Pilot Projects; D017828:Rifabutin / Q000008:administration & dosage*; D014376:Tuberculosis / Q000188:drug therapy*
D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D017828:Rifabutin; D007538:Isoniazid