Successful use of rifampicin for Hispanic foreign-born patients with latent tuberculosis infection.
METHODS
Four months of rifampicin (4R) is recommended for the treatment of latent tuberculosis infection (LTBI), although data regarding its use are limited. The majority of tuberculosis (TB) cases in the USA occur among foreign-born persons.


OBJECTIVE
To determine tolerability, hepatotoxicity and completion rates associated with 4R among foreign-born persons.


METHODS
We retrospectively evaluated 4R treatment among a cohort of predominantly Hispanic foreign-born LTBI patients in four Middle-Tennessee public health clinics from February 2000 to February 2004. Patients' charts were reviewed to abstract demographic, social and clinical data. 4R completion rates, new symptoms and hepatotoxicity (serum aminoalanine transferase >or=120U/l with gastrointestinal symptoms or >or=200 regardless of symptoms) were evaluated.


RESULTS
Of 749 patients treated, 571 (76%) completed 4R. Among all subjects, Hispanics had a lower risk of non-completion (OR 0.6, 95%CI 0.4-0.7) than non-Hispanics. Among non-Hispanic subjects, the risk of non-completion was higher for Blacks than non-Blacks (adjusted OR 2.6, 95%CI 1.5-4.7), but was lower for foreign-born than non-foreign-born subjects (adjusted OR 0.5, 95%CI 0.2-0.9). During treatment, 85 subjects (11%) developed new symptoms, and hepatotoxicity occurred in three patients.


CONCLUSIONS
With high completion rates and minimal side effects, 4R is a favorable LTBI treatment regimen for Hispanic and other foreign-born patients.
Haley
C A
CA
Tennessee Department of Health, Nashville, Tennessee, USA. Connie.haley@comcast.net
Stephan
S
S
Vossel
L F
LF
Sherfy
E A
EA
Laserson
K F
KF
Kainer
M A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D054242:Emigrants and Immigrants; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008099:Liver / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012293:Rifampin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D016312:Treatment Refusal; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000208:ethnology
D000904:Antibiotics, Antitubercular; D012293:Rifampin