Short-course rifamycin and pyrazinamide treatment for latent tuberculosis infection in patients with HIV infection: the 2-year experience of a comprehensive community-based program in Broward County, Florida.
OBJECTIVE
To determine the completion rate and tolerability of short-course rifamycin and pyrazinamide treatment of latent tuberculosis infection (LTBI) in HIV-infected patients through a comprehensive community-based program.


METHODS
Prospective cohort, with comparison to a historical control group.


METHODS
Of 3,118 patients with HIV infection screened for LTBI between February 1999 and March 2001, 135 patients were placed on rifamycin/pyrazinamide for 2 months under directly observed therapy and were compared to a historical group comprised of 93 HIV-infected patients who were placed on self-administered treatment of isoniazid for 12 months between 1996 and 1998.


RESULTS
Of 135 patients receiving rifamycin/pyrazinamide, 124 patients (92%) completed treatment; 5 patients had to discontinue treatment due to side effects (allergic skin reactions [n = 4], hepatitis [n = 1]). The completion rate of the historical group who received isoniazid therapy was 61% (57 of 93 patients; p < 0.001); none of those who received isoniazid experienced significant side effects.


CONCLUSIONS
In our experience, a comprehensive, community-based program of rifamycin/pyrazinamide for LTBI achieved significantly higher adherence than that of traditional isoniazid therapy, and thus may provide improved tuberculosis prevention in a community with high prevalence of HIV-infected patients.
Narita
Masahiro
M
Broward County Health Department, Fort Lauderdale, FL, USA.
Kellman
Michael
M
Franchini
Diana L
DL
McMillan
Marie E
ME
Hollender
Elena S
ES
Ashkin
David
D
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D015331:Cohort Studies; D003153:Community Health Services; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005431:Florida; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011336:Probability; D011446:Prospective Studies; D011718:Pyrazinamide / Q000008:administration & dosage*; D012293:Rifampin / Q000008:administration & dosage*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy*
D000995:Antitubercular Agents; D011718:Pyrazinamide; D012293:Rifampin