Treatment Regimens for Latent Tuberculosis Infection Compared

Isoniazid, rifampicin monotherapy, combination therapies can prevent active TB in latent TB infection
Isoniazid, rifampicin monotherapy, combination therapies can prevent active TB in latent TB infection

(HealthDay News) — Isoniazid monotherapy, rifampicin monotherapy, and combination therapies can be efficacious for preventing active tuberculosis (TB) among adults and children with latent TB infection (LTBI), according to research published online Aug. 1 in the Annals of Internal Medicine.

Dominik Zenner, M.D., from University College London, and colleagues conducted a systematic literature review to assess the comparative efficacy and harms of LTBI treatment regimens aimed at preventing active TB among adults and children. Data were included from eight new and 53 previously included studies.

The researchers found that, compared with placebo, isoniazid regimens of six months or 12 to 72 months (odds ratios, 0.65 and 0.50, respectively), rifampicin-only regimens (odds ratio, 0.41), rifampicin-isoniazid regimens of three to four months (odds ratio, 0.53), rifampicin-isoniazid-pyrazinamide regimens (odds ratio, 0.35), and rifampicin-pyrazinamide regimens (odds ratio, 0.53) were efficacious. Compared with no treatment, evidence existed for the efficacy of weekly rifapentine-isoniazid regimens (odds ratio, 0.36). There was no conclusive evidence to indicate that HIV status impacted the efficacy of treatment.

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"Evidence exists for the efficacy and safety of six-month isoniazid monotherapy, rifampicin monotherapy, and combination therapies with three to four months of isoniazid and rifampicin," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text