Thirty Years After Isoniazid

Hsu, Katharine H. K.

doi:10.1001/jama.1984.03340340023018

Cited by 96 publications

(16 citation statements)

References 7 publications

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“…Isoniazid preventive therapy (IPT) which has proven efficacy in preventing TB disease in infected and uninfected child contacts is recommended for child contacts <5 years of age who have no evidence of TB disease [8, 34, 35]. Yet IPT is rarely provided.…”

Section: Discussionmentioning

confidence: 99%

Contact Investigation of Children Exposed to Tuberculosis in South East Asia: A Systematic Review

Triasih

Rutherford

Lestari

et al. 2012

Journal of Tropical Medicine

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Background. Screening of children who are household contacts of tuberculosis (TB) cases is universally recommended but rarely implemented in TB endemic setting. This paper aims to summarise published data of the prevalence of TB infection and disease among child contacts in South East Asia. Methods. Search strategies were developed to identify all published studies from South East Asia of household contact investigation that included children (0–15 years). Results. Eleven studies were eligible for review. There was heterogeneity across the studies. TB infection was common among child contacts under 15 years of age (24.4–69.2%) and was higher than the prevalence of TB disease, which varied from 3.3% to 5.5%. Conclusion. TB infection is common among children that are household contacts of TB cases in South East Asia. Novel approaches to child contact screening and management that improve implementation in South East Asia need to be further evaluated.

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Section: Discussionmentioning

confidence: 99%

Contact Investigation of Children Exposed to Tuberculosis in South East Asia: A Systematic Review

Triasih

Rutherford

Lestari

et al. 2012

Journal of Tropical Medicine

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“…In addition, no disease reactivation was observed during adolescence, which suggests that the treatment provided long-term protection. (11) Individuals who have recently (within the past 12 months) undergone tuberculin conversion (to 10 mm of induration) are also considered a high-risk group. Children younger than 4 who have positive reactions (10 mm) should be considered recent reactors.…”

Section: Chemoprophylaxis In Infected Individuals (Secondary)mentioning

confidence: 99%

Quimioprofilaxia na prevenção da tuberculose

Pineda¹,

Pereira²,

Matos³

et al. 2004

J. bras. pneumol.

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Tuberculosis chemoprophylaxis is a therapeutic measure for the prevention of infection by Mycobacterium tuberculosis or to avoid development of the disease in individuals already infected with it. Isoniazid is the most commonly used therapy; however, the use of rifampicin and pyrazinamide has recently been introduced. The objectives of this study were to review the results of the principal studies evaluating the indications for chemoprophylaxis with isoniazid alone and in association with other drugs, its efficacy in the prevention of tuberculosis with respect to the different risk groups and the alternative regimens available. A systematic revision of the medical literature was carried out with particular emphasis on clinical trials and metaanalyses. Official records were also consulted. Those studies involving randomized clinical trials on the use of isoniazid, rifampicin or pyrazinamide in HIV-positive or negative patients were selected. Isoniazid continues to be effective for the prevention of tuberculosis in populations of both HIV-negative and HIV-positive individuals. The standard dose of 5-15 mg/kg/day has shown similar protection over treatment periods ranging from six to twelve months. The risk of developing hepatitis was less than 1%; however monitoring during treatment is recommended in patients over 35 years of age and in users of alcohol. Studies involving treatment regimens with other forms of medication were inconclusive and new studies would have to be performed to evaluate the efficacy of these regimens in populations at high risk of developing tuberculosis.

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“…7,8 Furthermore, postmortem studies have identified tuberculosis as a leading cause of death in HIV-infected children in Africa, accounting for 12 to 18% of deaths in these children. 9,10 Isoniazid has shown effectiveness in preventing progression to tuberculosis disease in children who had known contact with persons with infectious tuberculosis, 11-13 but its role in preexposure prophylaxis has not been evaluated in HIV-infected infants or uninfected children exposed to HIV during the perinatal period — both groups at increased risk for tuberculosis.…”

mentioning

confidence: 99%

Primary Isoniazid Prophylaxis against Tuberculosis in HIV-Exposed Children

Madhi¹,

et al. 2011

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Background The dual epidemic of human immunodeficiency virus (HIV) and tuberculosis is a major cause of sickness and death in sub-Saharan Africa. We conducted a double-blind, randomized, placebo-controlled trial of preexposure isoniazid prophylaxis against tuberculosis in HIV-infected children and uninfected children exposed to HIV during the perinatal period. Methods We randomly assigned 548 HIV-infected and 804 HIV-uninfected infants (91 to 120 days of age) to isoniazid (10 to 20 mg per kilogram of body weight per day) or matching placebo for 96 weeks. All patients received bacille Calmette–Guérin (BCG) vaccination against tuberculosis within 30 days after birth. HIV-infected children had access to antiretroviral therapy. The primary outcome measures were tuberculosis disease and death in HIV-infected children and latent tuberculosis infection, tuberculosis disease, and death in HIV-uninfected children within 96 to 108 weeks after randomization. Results Antiretroviral therapy was initiated in 98.9% of HIV-infected children during the study. Among HIV-infected children, protocol-defined tuberculosis or death occurred in 52 children (19.0%) in the isoniazid group and 53 (19.3%) in the placebo group (P = 0.93). Among HIV-uninfected children, there was no significant difference in the combined incidence of tuberculosis infection, tuberculosis disease, or death between the isoniazid group (39 children, 10%) and the placebo group (45 children, 11%; P = 0.44). The rate of tuberculosis was 121 cases per 1000 child-years (95% confidence interval [CI], 95 to 153) among HIV-infected children as compared with 41 per 1000 child-years (95% CI, 31 to 52) among HIV-uninfected children. There were no significant differences in clinical or severe laboratory toxic effects between treatment groups. Conclusions Primary isoniazid prophylaxis did not improve tuberculosis-disease–free survival among HIV-infected children or tuberculosis-infection–free survival among HIV-uninfected children immunized with BCG vaccine. Despite access to antiretroviral therapy, the burden of tuberculosis remained high among HIV-infected children. (Funded by the National Institutes of Health and Secure the Future; ClinicalTrials.gov number, NCT00080119.)

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Thirty Years After Isoniazid

Cited by 96 publications

References 7 publications

Contact Investigation of Children Exposed to Tuberculosis in South East Asia: A Systematic Review

Contact Investigation of Children Exposed to Tuberculosis in South East Asia: A Systematic Review

Quimioprofilaxia na prevenção da tuberculose

Primary Isoniazid Prophylaxis against Tuberculosis in HIV-Exposed Children

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