title: Anti-tuberculosis treatment outcomes in HIV-infected adults exposed to isoniazid preventive therapy in Botswana.
abstract: METHODS
  Eight public health clinics in Gaborone and Francistown, Botswana.
  
  
  OBJECTIVE
  To describe the characteristics and outcomes of incident tuberculosis (TB) cases in human immunodeficiency virus (HIV) infected adults exposed to isoniazid preventive therapy (IPT) with access  to antiretroviral and anti-tuberculosis treatment.
  
  
  METHODS
  In 1995 HIV-infected adults, TB disease was excluded before commencing IPT. During and after receipt of 6 or 36 months of IPT, symptomatic participants were evaluated using chest radiographs, sputum microscopy, cultures and drug  susceptibility testing (DST). Incident TB cases received ≥6 months of anti-tuberculosis treatment.
  
  
  RESULTS
  Seventy-five incident TB cases were identified among 619 symptomatic participants. The median duration of IPT in these cases was 6 months (range 1-35), and the median time  to initiation of anti-tuberculosis treatment was 12 months after IPT cessation. Antiretroviral therapy (ART) was initiated before anti-tuberculosis treatment in 37 cases. Culture was positive in 43/58 (74%) TB cultures. DST was available for 38 cases, of which six (16%) were resistant to isoniazid  (INH); 67/75 (89%) cases, including four with INH-monoresistant TB, completed anti-tuberculosis treatment or were cured.
  
  
  CONCLUSIONS
  With prompt initiation of anti-tuberculosis treatment and access to ART, excellent outcomes were achieved in a public health setting in HIV-infected adults  who developed TB disease.
authors: Centers for Disease Control and Prevention Botswana, Gaborone and Francistown, Botswana.
authors: T
authors: T
authors: Sibanda
authors: Z
authors: Z
authors: Tedla
authors: S
authors: S
authors: Nyirenda
authors: T
authors: T
authors: Agizew
authors: M
authors: M
authors: Marape
authors: A G
authors: AG
authors: Miranda
authors: H
authors: H
authors: Reuter
authors: J L
authors: JL
authors: Johnson
authors: T
authors: T
authors: Samandari
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000008:administration & dosage; D001902:Botswana / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007538:Isoniazid / Q000008:administration & dosage*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents; D007538:Isoniazid