Access and adherence to isoniazid preventive therapy and occurrence of active TB in a cohort of people living with HIV: a retrospective cohort study in Sao Paulo, Brazil

Picone, Camila de Melo; Freitas, Aldevina Campos de; Gutierrez, Eliana Battaggia; Avelino‐Silva, Vivian Iida

doi:10.1590/s1678-9946202062008

Cited by 6 publications

(3 citation statements)

References 27 publications

(24 reference statements)

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“…Primary outcomes Isoniazid vs. placebo or non-treatment Two NRSs compared the e cacy between isoniazid and non-treatment in 470 participants. The e cacy was similar in the two groups (OR: 0.62; 95%CI 0.17-2.26) (19,20). However, most active TB patients in isoniazid group in Picone et al's study were non-adherent to therapy (6 of the 14 non-adherent patients suffered active tuberculosis).…”

Section: Risk Of Bias Assessmentmentioning

confidence: 83%

“…In one trial, the non-treatment group being compared with the isoniazid group had variable "literacy" and "illicit drug use", and the adherence to isoniazid was self-reported (19). The reason why patients didn't receive prophylactic therapy in the other studies is not clear, however some patients with liver disease have concerns regarding the safety of isoniazid (20).…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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Latent tuberculosis infection therapy in people living with human immunodeficiency virus infection

Lin

Tsai

et al. 2023

Preprint

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Background The World Health Organization (WHO) suggests that some high-risk patient groups should receive latent tuberculosis infection (LTBI) screening and tuberculosis prevention treatment, including people living with human immunodeficiency virus (PLHIV). We performed an updated meta-analysis to compare the different LTBI therapeutic regimens for LTBI test-positive PLHIV. Methods We searched PubMed, Embase, Cochrane library, clinicaltrials.gov, and the International Clinical Trials Registry Platform for all literature and ongoing trials from their inception until November 30th, 2022. We performed a meta-analysis of the efficacy, adhesion rate, and severe adverse events; and graded the evidence quality. Results Nine studies were eligible, including two non-randomized studies (NRS) with 470 participants and seven randomized control trials (RCT)with 3,979 participants. The quality of evidence was very low for the results of the NRSs and low for the RCTs. Compared with placebo or non-treatment, both isoniazid (OR: 0.56; 95%CI 0.33-0.93) and rifamycin-based treatments (OR: 0.44; 95%CI 0.26-0.72) had efficacy for active TB prevention. Rifamycin-based regimens seem to have a better adhesion rate than isoniazid alone (RR: 1.11; 95%CI 1.04-1.19) and similar adverse events (RR: 0.73; 95%CI 0.49-1.09). Conclusions LTBI treatment decreased the active rate of TB in LTBI test-positive PLHIV. Rifamycin-based therapies may have a higher adhesion rate, while their efficacy and adverse events appear similar to isoniazid. More studies focusing on LTBI test-positive PLHIV participants would help gather high-quality evidence for decision-making.

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Section: Risk Of Bias Assessmentmentioning

confidence: 83%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Latent tuberculosis infection therapy in people living with human immunodeficiency virus infection

Lin

Tsai

et al. 2023

Preprint

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“…In TB cases caused by M. tuberclosis mycrobacteria in the past, with the development and use of antimicrobials, mortality rates decreased significantly and TB ceased to be an important public health. However, as a result of the development of multi drug resistant TB and extensive drug resistant TB and the increase of immune system disrupting diseases such as HIV, TB has become one of the most important global health problems and deaths caused by infections [17][18][19][20] . In our study, according to WHO ICD-10 data, it was observed that tuberculosis-related deaths were reported in 14 countries in the world, of which 12 countries had tuberculosis-related deaths over a year.…”

Section: Discussionmentioning

confidence: 99%

Examination of Surgically Important Healthy Life Expectancy and Respiratory Tract Deaths: The Relationship between Tuberculosis-Related Deaths and Health Adjusted Life Expectancy (HALE)

ÖZSAN

2022

ijirms

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Background: The aim of the research is to evaluate the relationship between surgically important healthy life expectancy and respiratory tract deaths on the relationship between tuberculosis-related deaths and Health Adjusted Life Expectancy (HALE). Methods: ICD-10 (International Classification of Diseases 10th Revision) mortality and HALE data of WHO were used. In ICD-10 mortality data, a total of 12 countries have been reported tuberculosis caused deaths from 1996 to 2017. In total, 7 countries had sufficient data for panel data analyze from 2000 to 2011. Results: Tuberculosis caused female, male and total deaths were negatively correlated with HALE at birth and HALE at 60 ages (p<0.01). HALE at birth and HALE at 60 ages did not have significant contribution to tuberculosis related deaths for both genders and in total (p>0.05). Fixed, random or time fixed models did not explain effects of HALE on tuberculosis related deaths. Conclusion: Mortality of tuberculosis is more common in males, and in respiratory related TB. It is suggested to examine the effects of diseases that decrease life expectancy specifically on HALE. In this regard, the research may lead to studies examining the relationship between other mortality-related diseases and HALE in Public Health Perspective.

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The latent tuberculosis cascade-of-care among people living with HIV: A systematic review and meta-analysis

et al. 2021

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Background Tuberculosis preventive therapy (TPT) reduces TB-related morbidity and mortality in people living with HIV (PLHIV). Cascade-of-care analyses help identify gaps and barriers in care and develop targeted solutions. A previous latent tuberculosis infection (LTBI) cascade-of-care analysis showed only 18% of persons in at-risk populations complete TPT, but a similar analysis for TPT among PLHIV has not been completed. We conducted a meta-analysis to provide this evidence. Methods and findings We first screened potential articles from a LTBI cascade-of-care systematic review published in 2016. From this study, we included cohorts that reported a minimum of 25 PLHIV. To identify new cohorts, we used a similar search strategy restricted to PLHIV. The search was conducted in Medline, Embase, Health Star, and LILACS, from January 2014 to February 2021. Two authors independently screened titles and full text and assessed risk of bias using the Newcastle–Ottawa Scale for cohorts and Cochrane Risk of Bias for cluster randomized trials. We meta-analyzed the proportion of PLHIV completing each step of the LTBI cascade-of-care and estimated the cumulative proportion retained. These results were stratified based on cascades-of-care that used or did not use LTBI testing to determine eligibility for TPT. We also performed a narrative synthesis of enablers and barriers of the cascade-of-care identified at different steps of the cascade. A total of 71 cohorts were included, and 70 were meta-analyzed, comprising 94,011 PLHIV. Among the PLHIV included, 35.3% (33,139/94,011) were from the Americas and 29.2% (27,460/94,011) from Africa. Overall, 49.9% (46,903/94,011) from low- and middle-income countries, median age was 38.0 [interquartile range (IQR) 34.0;43.6], and 65.9% (46,328/70,297) were men, 43.6% (29,629/67,947) were treated with antiretroviral therapy (ART), and the median CD4 count was 390 cell/mm3 (IQR 312;458). Among the cohorts that did not use LTBI tests, the cumulative proportion of PLHIV starting and completing TPT were 40.9% (95% CI: 39.3% to 42.7%) and 33.2% (95% CI: 31.6% to 34.9%). Among cohorts that used LTBI tests, the cumulative proportions of PLHIV starting and completing TPT were 60.4% (95% CI: 58.1% to 62.6%) and 41.9% (95% CI:39.6% to 44.2%), respectively. Completion of TPT was not significantly different in high- compared to low- and middle-income countries. Regardless of LTBI test use, substantial losses in the cascade-of-care occurred before treatment initiation. The integration of HIV and TB care was considered an enabler of the cascade-of-care in multiple cohorts. Key limitations of this systematic review are the observational nature of the included studies, potential selection bias in the population selection, only 14 cohorts reported all steps of the cascade-of-care, and barriers/facilitators were not systematically reported in all cohorts. Conclusions Although substantial losses were seen in multiple stages of the cascade-of-care, the cumulative proportion of PLHIV completing TPT was higher than previously reported among other at-risk populations. The use of LTBI testing in PLHIV in low- and middle-income countries was associated with higher proportion of the cohorts initiating TPT and with similar rates of completion of TPT.

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Access and adherence to isoniazid preventive therapy and occurrence of active TB in a cohort of people living with HIV: a retrospective cohort study in Sao Paulo, Brazil

Cited by 6 publications

References 27 publications

Latent tuberculosis infection therapy in people living with human immunodeficiency virus infection

Latent tuberculosis infection therapy in people living with human immunodeficiency virus infection

Examination of Surgically Important Healthy Life Expectancy and Respiratory Tract Deaths: The Relationship between Tuberculosis-Related Deaths and Health Adjusted Life Expectancy (HALE)

The latent tuberculosis cascade-of-care among people living with HIV: A systematic review and meta-analysis

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