Efficacy of secondary isoniazid preventive therapy among HIV-infected Southern Africans: time to change policy?
AIDS
; 17(14): 2063-70, 2003 Sep 26.
Article
en En
| MEDLINE
| ID: mdl-14502009
ABSTRACT
OBJECTIVE:
To determine the efficacy of secondary preventive therapy against tuberculosis (TB) among gold miners working in South Africa.DESIGN:
An observational study.SETTING:
Health service providing comprehensive care for gold miners.METHODS:
The incidence of recurrent TB was compared between two cohorts of HIV-infected miners one cohort (n = 338) had received secondary preventive therapy with isoniazid (IPT) and the other had not (n = 221).RESULTS:
The overall incidence of recurrent TB was reduced by 55% among men who received IPT compared with those who did not (incidence rates 8.6 and 19.1 per 100 person-years, respectively; incidence rate ratio, 0.45; 95% confidence interval 0.26-0.78). The efficacy of isoniazid preventive therapy was unchanged after controlling for CD4 cell count and age. The number of person-years of IPT required to prevent one case of recurrent TB among individuals with a CD4 cell count < 200 x 106 cells/l, and > or = 200 x 106 cells/l was 5 and 19, respectively.CONCLUSION:
Secondary preventive therapy reduces TB recurrence the absolute impact appears to be greatest among individuals with low CD4 cell counts. International TB preventive therapy guidelines for HIV-infected individuals need to be expanded to include recommendations for secondary preventive therapy in settings where TB prevalence is high.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tuberculosis
/
Infecciones por VIH
/
Isoniazida
/
Minería
/
Enfermedades Profesionales
/
Antituberculosos
Tipo de estudio:
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Africa
Idioma:
En
Revista:
AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2003
Tipo del documento:
Article
País de afiliación:
Sudáfrica