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Rifampicin plus isoniazid for the prevention of tuberculosis in an immigrant population

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OBJECTIVES: To compare the tolerance, adherence and effectiveness of two approaches for the treatment of latent tuberculosis infection (LTBI): 6 months of isoniazid (6H) vs. 3 months of isoniazid plus rifampicin (3RH).

POPULATION: Immigrants with LTBI.

METHODS: Participants were enrolled in a controlled, randomised clinical trial in Barcelona, Spain, from April 2001 to April 2005. Monthly follow-up was done to assess tolerance, side effects and adherence. Effectiveness was evaluated at 5 years.

RESULTS: In the 590 subjects enrolled, the rate of adherence was greater in the 3RH than in the 6H arm (72% vs. 52.4%, P = 0.001). No differences between study arms were observed with respect to hepatotoxicity or side effects. Variables associated with non-adherence were diagnosis by screening (OR 1.88, 95%CI 1.26–2.82, P = 0.001), illegal immigration status (OR 1.48, 95%CI 1.01–2.15, P = 0.03), unemployment (OR 1.91, 95%CI 1.28–2.85, P = 0.0008), illiteracy (OR 1.73, 95%CI 1.04–2.88, P = 0.02), lack of family support (OR 3.7, 95%CI 2.54–5.4, P = 0.001) and the 6-month treatment regimen (OR 2.45, 95%CI 1.68–3.57, P = 0.0001). None of the patients who completed either treatment developed tuberculosis.

CONCLUSIONS: The 3RH regimen facilitates adherence to LTBI treatment and offers a safe, well-tolerated and effective alternative.

Keywords: immigration; isoniazid; latent tuberculosis infection; randomised clinical trial; rifampicin

Document Type: Research Article

Affiliations: Unidad de Prevención y Control de la Tuberculosis de Barcelona, Servei d'Atenció Primària Suport al Diagnóstic i al Tractament, Institut Català de la Salut, Barcelona, Spain

Publication date: 01 March 2013

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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