Isoniazid therapy for Mycobacterium tuberculosis infection in HIV clinics, Los Angeles, California.
Publicly funded human immunodeficiency virus (HIV) clinics in Los Angeles County, California, USA.



HIV-infected persons are a high priority group for targeted testing and treatment for Mycobacterium tuberculosis infection in the United States.



To describe rates of isoniazid (INH) initiation and completion among HIV-1 and M. tuberculosis co-infected persons in Los Angeles County.



We conducted a cross-sectional study using routinely collected surveillance data from publicly funded HIV clinics. We examined differences in INH treatment initiation and completion between four clinic categories: the three largest clinics (Clinics A, B, and C) and 'Other' clinics (pooled data for the remaining 10 clinics).



During 2010-2013, 802 (5.3%) of 15 029 HIV-1-infected persons tested positive for M. tuberculosis infection. INH was initiated in 581 (72.4%) persons, of whom 457 (78.7%) completed treatment. We found significant differences between clinics in terms of treatment initiation (range 59.1-93.4%) and completion (range 58.8-82.3%). Overall, 57% (457/802) of HIV and M. tuberculosis co-infected persons completed the recommended treatment (range across clinics 34.8-76.3%).



We identified significant gaps in the treatment for M. tuberculosis infection among HIV-infected persons in Los Angeles County. Interventions are needed to improve initiation and completion of treatment for M. tuberculosis infection in this population.
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, USA; Tuberculosis Control Program, Los Angeles County Department of Public Health, Los Angeles, USA.
S S
SS
Shin
Tuberculosis Control Program, Los Angeles County Department of Public Health, Los Angeles, USA; Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, USA.
A H
AH
Chang
Tuberculosis Control Program, Los Angeles County Department of Public Health, Los Angeles, USA.
J K C
JK
Ghosh
Keck School of Medicine, University of Southern California, Los Angeles, USA.
M P
MP
Dubé
Los Angeles LGBT Center, Los Angeles, USA.
R
R
Bolan
David Geffen School of Medicine, University of California, Los Angeles, AIDS Healthcare Foundation, Los Angeles, California, USA.
O O
OO
Yang
Tuberculosis Control Program, Los Angeles County Department of Public Health, Los Angeles, USA.
P R
PR
Kerndt
D000328:Adult; D000554:Ambulatory Care Facilities; D000995:Antitubercular Agents / Q000627:therapeutic use*; D060085:Coinfection; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D017150:Public Sector; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents; D007538:Isoniazid