POPLINE Document Number: 141303
Author(s):
Bucher HC
Griffith LE
Guyatt GH
Sudre P
Naef M
Sendi P
Battegay M
Source citation:
AIDS, 1999;13(4):501-7.
Abstract:
Infection with M. tuberculosis is the most common bacterial infection in humans, and HIV infection is the strongest risk factor for tuberculosis (TB). The World Health Organization estimates that more than 4 million people, mostly in Africa, are coinfected with both organisms. Randomized controlled trials, however, have demonstrated that isoniazid (INH) prophylaxis may reduce the incidence of TB in HIV-negative populations at high risk of developing active disease. The efficacy of INH in preventing TB in tuberculin skin test-positive and negative individuals with HIV infection was assessed through the meta-analysis of 7 randomized controlled trials from Mexico, Haiti, the US, Zambia, Uganda, and Kenya. Findings are based upon 2367 subjects treated with INH and 2162 in control and placebo groups. The mean follow-up of trial participants varied between 0.4 and 3.2 years. Pooling all 7 trials, the risk ratio (RR) of INH versus placebo for TB was 0.58, and 0.94 for death. In groups of tuberculin skin test-positive and -negative subjects, the RR of TB was 0.40 and 0.84, respectively, and the difference in the effectiveness of INH versus placebo between the groups was statistically significant. Consistency of results was found across trials for all comparisons. Prophylaxis with INH therefore reduces the risk of TB in HIV-infected individuals. However, the effect is limited to tuberculin skin test-positive persons.
Keywords:
MexicoIndex page
Haiti
United States
Zambia
Uganda
Kenya
Research Report
Literature Review
Drugs
Treatment
Tuberculosis
HIV Infections
AIDS
Prevention and Control
North America
Latin America
Americas
Developing Countries
Caribbean
Developed Countries
North America
Africa, Southern
Africa, Sub Saharan
Africa
Africa, Eastern
Infections
Diseases
Viral Diseases