title: Twelve-Week Rifapentine Plus Isoniazid Versus 9-Month Isoniazid for the Treatment of Latent Tuberculosis in Renal Transplant Candidates.
abstract: Renal transplant candidates (RTC) with latent tuberculosis infection (LTBI) are at significant risk for tuberculosis reactivation. Twelve-week rifapentine (RPT)/isoniazid (INH) is effective for LTBI but clinical experience in RTC is scarce.
  
  
  
  We conducted a retrospective study of RTC with LTBI treated with either 12-week RPT/INH or 9-month INH from March 1, 2012, through February 28, 2014. We evaluated both groups for differences in rates of treatment completion, monthly follow-up visit compliance, transaminase elevations, and adverse reactions leading to discontinuation of LTBI treatment. The utility of weekly reminders was also evaluated in the 12-week regimen. Direct observed therapy was not performed in our study.
  
  
  
  Of 153 patients, 43 (28%) and 110 (72%) were started on 12-week RPT/INH and 9-month INH, respectively. The treatment completion and monthly follow-up visit compliance rates were higher in the 12-week RPT/INH group (40 [93%] vs 52 [47%], P < 0.001) and (11/40 [28%] vs 13/104 [13%], P = 0.03), respectively. Transaminase elevations were not observed in the RPT/INH group, but occurred in 6 (5%) of the INH group. There were no differences in adverse reactions leading to discontinuation of LTBI treatment.
  
  
  
  Twelve-week RPT/INH appears to be an excellent choice for LTBI in RTC. It has a higher treatment completion rate and causes less transaminase elevations, and weekly reminders may be an alternative when direct observed therapy is not feasible.
authors.affiliation: 1 Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Jacques
authors.initials: J
authors.lastname: Simkins
authors.forename: Lilian Margarita
authors.initials: LM
authors.lastname: Abbo
authors.forename: Jose Fernando
authors.initials: JF
authors.lastname: Camargo
authors.forename: Rossana
authors.initials: R
authors.lastname: Rosa
authors.forename: Michele Ileana
authors.initials: MI
authors.lastname: Morris
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000209:etiology; D002755:Choice Behavior; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage* / Q000009:adverse effects; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017010:Reminder Systems; D012189:Retrospective Studies; D012293:Rifampin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D000637:Transaminases / Q000097:blood; D016896:Treatment Outcome; D016312:Treatment Refusal; D015854:Up-Regulation; D014850:Waiting Lists
chemical_list: D000995:Antitubercular Agents; D015415:Biomarkers; D000637:Transaminases; D007538:Isoniazid; D012293:Rifampin; C018421:rifapentine