Important note: Information in this article was accurate in May 2000. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, May 1, 2000
Prepared by AIDS Weekly editors from staff and other reports
The study was reported in a recent edition of the Journal of the American Medical Association ("Rifampin and pyrazinamide vs. isoniazid for prevention of tuberculosis in HIV-infected persons - An international randomized trial," JAMA 2000 Mar 15;283(11):1445-50.
More than 1,500 HIV patients with a positive tuberculin skin test were enrolled in the study. According to F. Gordin and colleagues at the Veteran Affairs Medical Center in Washington, DC, patients were randomized to receive either short-term rifampin/pyrazinamide therapy (two months), or long-term isoniazid therapy (12 months).
Eighty percent of the rifampin/pyrazinamide patients completed the full course of treatment while 69% of the isoniazid patients completed their treatment regimen.
"After a mean follow-up of 37 months, 19 patients (2.4%) assigned to rifampin and pyrazinamide and 26 (3.3%) assigned to isoniazid developed confirmed tuberculosis at rates of 0.8 and 1.1 per 100 person-years, respectively (risk ratio, 0.72 [95% confidence interval, 0.40-1.31]; P=.28)," Gordin and colleagues announced.
They could find no significant differences in factors such as confirmed tuberculosis, HIV progression, death, or adverse advents, they added. However, they did report that drug discontinuation was slightly higher in the rifampin/pyrazinamide patient group.
Finally, they could find no evidence that drug-resistant tuberculosis developed with use of either of the regimens.
Gordin and co-authors concluded, "Our data suggest that for preventing tuberculosis in HIV infected patients, a daily two-month regimen of rifampin and pyrazinamide is similar in safety and efficacy to a daily 12-month regimen of isoniazid. This shorter regimen offers practical advantages to both patients and tuberculosis control programs."
The corresponding author for this study is F. Gordin, Veteran Affairs Medical Center, 50 Irving Street North West, Washington, DC 20422, USA.
Key points reported in this study are:
This article was prepared by AIDS Weekly editors from staff and other reports.
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