Effectiveness and safety of isoniazid chemoprophylaxis for HIV-1 infected patients from Rio de Janeiro.
The clinical and epidemiological characteristics, adverse events, treatment adherence and effectiveness of isoniazid chemoprophylaxis were analyzed in a cohort of 138 tuberculosis/HIV-coinfected patients. An open, non-randomized, pragmatic prophylactic trial was conducted on adult patients with a normal chest X-ray and positive tuberculin skin test (>or= 5 mm) who received isoniazid chemoprophylaxis (300 mg/day) for six months. The mean of follow up was 2.8 years (SD 1.3). Adherence to chemoprophylaxis was 87.7% (121/138). Only one patient presented tuberculosis after the end of chemoprophylaxis, corresponding to 0.3 cases per 100 persons per year. The relative risk of some adverse effects was 4.6 times higher (95% CI: 1.9-11.5) in patients with positive anti-HCV serology (4/9, 44.4%) compared to those with negative serology (12/129, 9.6%) (p = 0.002). This study provides evidence regarding the effectiveness and safety of a short and self-administered isoniazid regimen. We recommend the implementation of this routine by health service practitioners.
Souza
Claudia Teresa Vieira de
CT
Laboratório de Epidemiologia Clínica, Instituto Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. clau@fiocruz.br
Hökerberg
Yara Hahr Marques
YH
Pacheco
Sandro Javier Bedoya
SJ
Rolla
Valéria Cavalcanti
VC
Passos
Sonia Regina Lambert
SR
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control*; D000328:Adult; D019072:Antibiotic Prophylaxis; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000517:prevention & control*; D019562:Viral Load
D000995:Antitubercular Agents; D007538:Isoniazid