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- Title
Long-Term Protective Effect of Tuberculosis Preventive Therapy in a Medium/High Tuberculosis Incidence Setting.
- Authors
Teixeira, Leidy Anne Alves; Santos, Braulio; Correia, Marcelo Goulart; Valiquette, Chantal; Bastos, Mayara Lisboa; Menzies, Dick; Trajman, Anete
- Abstract
Background The duration of the protective effect of tuberculosis preventive therapy (TPT) is controversial. Some studies have found that the protective effect of TPT is lost after cessation of therapy among people with human immunodeficiency virus (HIV) in settings with very high tuberculosis incidence, but others have found long-term protection in low-incidence settings. Methods We estimated the incidence rate (IR) of new tuberculosis disease for up to 12 years after randomization to 4 months of rifampin or 9 months of isoniazid, among 991 Brazilian participants in a TPT trial in the state of Rio de Janeiro, with an incidence of 68.6/100 000 population in 2022. The adjusted hazard ratios (aHRs) of independent variables for incident tuberculosis were calculated. Results The overall tuberculosis IR was 1.7 (95% confidence interval [CI], 1.01– 2.7) per 1000 person-years (PY). The tuberculosis IR was higher among those who did not complete TPT than in those who did (2.9 [95% CI, 1.3–5.6] vs 1.1 [.4–2.3] per 1000 PY; IR ratio, 2.7 [1.0–7.2]). The tuberculosis IR was higher within 28 months after randomization (IR, 3.5 [95% CI, 1.6–6.6] vs 1.1 [.5–2.1] per 1000 PY between 28 and 143 months; IR ratio, 3.1 [1.2–8.2]). Treatment noncompletion was the only variable associated with incident tuberculosis (aHR, 3.2 [95% CI, 1.1–9.7]). Conclusions In a mostly HIV-noninfected population, a complete course of TPT conferred long-term protection against tuberculosis.
- Subjects
BRAZIL; TUBERCULOSIS epidemiology; TUBERCULOSIS prevention; HIV prevention; ISONIAZID; STATISTICAL significance; DESCRIPTIVE statistics; ANTITUBERCULAR agents; KAPLAN-Meier estimator; LOG-rank test; CONFIDENCE intervals; DATA analysis software; RIFAMPIN; DISEASE incidence
- Publication
Clinical Infectious Diseases, 2024, Vol 78, Issue 5, p1321
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciae101