Short-course rifamycin and pyrazinamide treatment for latent tuberculosis infection in patients with HIV infection: the 2-year experience of a comprehensive community-based program in Broward County, Florida

Chest. 2002 Oct;122(4):1292-8. doi: 10.1378/chest.122.4.1292.

Abstract

Objectives: To determine the completion rate and tolerability of short-course rifamycin and pyrazinamide treatment of latent tuberculosis infection (LTBI) in HIV-infected patients through a comprehensive community-based program.

Design: Prospective cohort, with comparison to a historical control group.

Patients: Of 3,118 patients with HIV infection screened for LTBI between February 1999 and March 2001, 135 patients were placed on rifamycin/pyrazinamide for 2 months under directly observed therapy and were compared to a historical group comprised of 93 HIV-infected patients who were placed on self-administered treatment of isoniazid for 12 months between 1996 and 1998.

Results: Of 135 patients receiving rifamycin/pyrazinamide, 124 patients (92%) completed treatment; 5 patients had to discontinue treatment due to side effects (allergic skin reactions [n = 4], hepatitis [n = 1]). The completion rate of the historical group who received isoniazid therapy was 61% (57 of 93 patients; p < 0.001); none of those who received isoniazid experienced significant side effects.

Conclusion: In our experience, a comprehensive, community-based program of rifamycin/pyrazinamide for LTBI achieved significantly higher adherence than that of traditional isoniazid therapy, and thus may provide improved tuberculosis prevention in a community with high prevalence of HIV-infected patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / drug therapy*
  • Adult
  • Aged
  • Antitubercular Agents / administration & dosage*
  • Case-Control Studies
  • Cohort Studies
  • Community Health Services
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Florida
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance
  • Probability
  • Prospective Studies
  • Pyrazinamide / administration & dosage*
  • Rifampin / administration & dosage*
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Treatment Outcome
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / drug therapy*

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Rifampin