title: [Effectiveness of prophylaxis against tuberculosis in patients infected with HIV].
abstract: BACKGROUND
  Prophylaxis against tuberculosis has been recognized as important for preventing clinical forms of tuberculosis, mainly in HIV positive patients. However, in countries with high tuberculosis prevalence, prophylaxis application and effectiveness remains controversial.
  
  
  OBJECTIVE
  Effectiveness was established for two prophylaxis regimens -isoniazid treatment for nine months and pirazinamid/rifampin for 60 days.
  
  
  METHODS
  Two cohort groups of patients diagnosed with HIV/AIDS were compared. One consisted of 131 volunteer patients, who received one of the two prophylactic regimens -pirazinamid/rifampin or isoniazid. The tuberculosis treatment drugs were self-administered and independent of tuberculin response tests. The second group consisted of 200 patients selected from the records of a HIV/AIDS control program. Follow up for both groups was conducted over a two-year period through clinical records.
  
  
  RESULTS
  The 2 groups were similar with respect to clinical and demographic variables. A higher proportion of patients in the control group had CD4 counts <200/ml and viral load >100,000 copies. In the prophylactic group, 8% of patients reported adverse effects due to the drug, and one person had tuberculosis in that group (0.8%). Ten persons in the control group contracted tuberculosis (5%) RR=0.15, 95%CI 0.02-1.18, p=0.07. The prophylaxis protective level was calculated to be 80%, after taking into account CD4, viral load, and effective antiretroviral therapy.
  
  
  CONCLUSIONS
  The prophylaxis against tuberculosis was effective in HIV positive patients, independently of the immune status, viral load, and highly effective antiretroviral therapy.
authors.affiliation: Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia. mpam@guajiros.udea.edu.co
authors.forename: María Patricia
authors.initials: MP
authors.lastname: Arbeláez
authors.forename: Alexánder
authors.initials: A
authors.lastname: Arbeláez
authors.forename: Rubén Darío
authors.initials: RD
authors.lastname: Gómez
authors.forename: Carlos
authors.initials: C
authors.lastname: Rojas
authors.forename: Lázaro
authors.initials: L
authors.lastname: Vélez
authors.forename: Sonia Luz
authors.initials: SL
authors.lastname: Arias
authors.forename: Jorge
authors.initials: J
authors.lastname: Nagles
authors.forename: Luz Marina
authors.initials: LM
authors.lastname: Peláez
authors.forename: Gloria
authors.initials: G
authors.lastname: Betancourt
authors.forename: Gloria
authors.initials: G
authors.lastname: Velásquez
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012293:Rifampin / Q000627:therapeutic use*; D015996:Survival Rate; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D019562:Viral Load
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin