title: Eligibility for and outcome of treatment of latent tuberculosis infection in a cohort of HIV-infected people in Spain.
abstract: BACKGROUND
  Previous studies have demonstrated the efficacy of treatment for latent tuberculosis infection (TLTBI) in persons infected with the human immunodeficiency virus, but few studies have investigated the operational aspects of implementing TLTBI in the co-infected population.The study objectives were to describe eligibility for TLTBI as well as treatment prescription, initiation and completion in an HIV-infected Spanish cohort and to investigate factors associated with treatment completion.
  
  
  METHODS
  Subjects were prospectively identified between 2000 and 2003 at ten HIV hospital-based clinics in Spain. Data were obtained from clinical records. Associations were measured using the odds ratio (OR) and its 95% confidence interval (95% CI).
  
  
  RESULTS
  A total of 1242 subjects were recruited and 846 (68.1%) were evaluated for TLTBI. Of these, 181 (21.4%) were eligible for TLTBI either because they were tuberculin skin test (TST) positive (121) or because their TST was negative/unknown but they were known contacts of a TB case or had impaired immunity (60). Of the patients eligible for TLTBI, 122 (67.4%) initiated TLTBI: 99 (81.1%) were treated with isoniazid for 6, 9 or 12 months; and 23 (18.9%) with short-course regimens including rifampin plus isoniazid and/or pyrazinamide. In total, 70 patients (57.4%) completed treatment, 39 (32.0%) defaulted, 7 (5.7%) interrupted treatment due to adverse effects, 2 developed TB, 2 died, and 2 moved away. Treatment completion was associated with having acquired HIV infection through heterosexual sex as compared to intravenous drug use (OR:4.6; 95% CI:1.4-14.7) and with having taken rifampin and pyrazinamide for 2 months as compared to isoniazid for 9 months (OR:8.3; 95% CI:2.7-24.9).
  
  
  CONCLUSIONS
  A minority of HIV-infected patients eligible for TLTBI actually starts and completes a course of treatment. Obstacles to successful implementation of this intervention need to be addressed.
authors.affiliation: Unidad de Epidemiología del VIH/SIDA, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain. adiaz@isciii.es
authors.forename: Asuncion
authors.initials: A
authors.lastname: Diaz
authors.forename: Mercedes
authors.initials: M
authors.lastname: Diez
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Bleda
authors.forename: Mikel
authors.initials: M
authors.lastname: Aldamiz
authors.forename: Miguel
authors.initials: M
authors.lastname: Camafort
authors.forename: Xabier
authors.initials: X
authors.lastname: Camino
authors.forename: Concepcion
authors.initials: C
authors.lastname: Cepeda
authors.forename: Asuncion
authors.initials: A
authors.lastname: Costa
authors.forename: Oscar
authors.initials: O
authors.lastname: Ferrero
authors.forename: Paloma
authors.initials: P
authors.lastname: Geijo
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Iribarren
authors.forename: Santiago
authors.initials: S
authors.lastname: Moreno
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Moreno
authors.forename: Pablo
authors.initials: P
authors.lastname: Labarga
authors.forename: Javier
authors.initials: J
authors.lastname: Pinilla
authors.forename: Joseba
authors.initials: J
authors.lastname: Portu
authors.forename: Federico
authors.initials: F
authors.lastname: Pulido
authors.forename: Carmen
authors.initials: C
authors.lastname: Rosa
authors.forename: Juan Miguel
authors.initials: JM
authors.lastname: Santamaría
authors.forename: Mauricio
authors.initials: M
authors.lastname: Telenti
authors.forename: Luis
authors.initials: L
authors.lastname: Trapiella
authors.forename: Monica
authors.initials: M
authors.lastname: Trastoy
authors.forename: Pompeyo
authors.initials: P
authors.lastname: Viciana
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D055985:Latent Tuberculosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D000995:Antitubercular Agents