[Effectiveness of prophylaxis against tuberculosis in patients infected with HIV].
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.
Arbeláez
María Patricia
MP
Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia. mpam@guajiros.udea.edu.co
Arbeláez
Alexánder
A
Gómez
Rubén Darío
RD
Rojas
Carlos
C
Vélez
Lázaro
L
Arias
Sonia Luz
SL
Nagles
Jorge
J
Peláez
Luz Marina
LM
Betancourt
Gloria
G
Velásquez
Gloria
G
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
D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin