Baltimore Sun (07.15.04) - Thursday, July 15, 2004
Jonathan Bor

The Consortium to Respond Effectively to the AIDS-TB Epidemics (Create), which includes CDC and World Health Organization scientists along with researchers from London, South Africa and Brazil, will use the drug isoniazid in TB-exposed people to keep them from getting active TB. Isoniazid has been used in Western countries for about 50 years but is rarely used in the developing world.

"There has been a belief that giving preventative therapies is not effective for controlling the disease," said Dr. Richard Chaisson, who is leading the effort. "I think there is very good evidence that's not correct." According to Chaisson, who directs the Johns Hopkins Center for Tuberculosis Research, HIV and TB can amplify each other, especially in developing nations where medicines and primary health care are lacking.

"Anyone concerned about HIV/AIDS must also be concerned about TB because the two diseases go hand in hand," said Dr. Helene Gayle, a Gates Foundation official.

Hopkins will oversee the three projects covered by the grant - one in Brazil and two in Africa. In Rio de Janeiro, researchers will give isoniazid to over 20,000 people coinfected with HIV and TB who have access to antiretroviral drugs to determine if adding isoniazid can prevent TB or slow its transmission.

In South Africa, the Create team will give isoniazid to two groups of gold miners to assess whether a mass assault on TB is better than a targeted strategy when both diseases are rampant. All the miners in one group will receive the drug; in the other, only those with HIV will get it. The third project will be conducted in Zambia and South Africa to assess whether TB rates can be reduced through education in schools and in community settings. Create scientists will also test the benefits of providing isoniazid to all members of TB patients' households.
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