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Sustained effect of isoniazid preventive therapy among household contacts in Brazil
Ist Teil von
The international journal of tuberculosis and lung disease, 2022-05, Vol.26 (5), p.406-411
Ort / Verlag
France
Erscheinungsjahr
2022
Quelle
MEDLINE
Beschreibungen/Notizen
Isoniazid preventive therapy (IPT) is highly effective in preventing TB disease; however, its long-term benefit in household contacts (HHCs) of infectious TB cases is unclear.
We conducted a retrospective analysis of two household contact studies in Vitoria, ES, Brazil, between 2008 and 2015. Households with smear-positive, culture-proven TB disease were enrolled. Eligible HHCs with tuberculin skin test (TST) indurations of ≥10 mm were referred to local TB clinics and IPT was started according to national guidelines. We reviewed the national dataset information system in January 2020 to identify HHCs with a diagnosis of TB disease. Time to event and Cox proportional regression analysis were conducted to identify factors associated with TB disease.
Of the 1097 HHCs enrolled, 654 (60%) had TST ≥10 mm; 160 (24%) initiated IPT, of whom 115 (71.9%) completed IPT, which accounts for an overall completion rate of 18% among the population at risk; 42 (6%) TB cases were identified. IPT was associated with a 71% decrease in TB disease rates (HR 0.29, 95% CI 0.10-0.82;
= 0.02) among HHCs with TST ≥10 mm. IPT effect was sustained, as TB cases in HHCs without IPT occurred along the 7.9-year follow-up, whereas all four TB cases in HHCs with IPT were diagnosed within the first 3 years after exposure
Isoniazid provides long-term protection for TB disease in household contacts of culture-proven TB cases.