Combination of Isoniazid, HAART More Effective at Preventing TB in HIV-Positive Patients Than Monotherapy, Study Says

A combination of the antibiotic isoniazid and highly active antiretroviral therapy is more effective at preventing active tuberculosis among HIV-positive people than the two treatments on their own, according to a study presented Monday at the XVI International AIDS Conference, Health-e News reports. Richard Chaisson, a professor of infectious diseases at Johns Hopkins University, and colleagues examined the medical records of more than 11,000 HIV-positive adults in Rio de Janeiro, Brazil. The researchers found that the risk of developing TB was reduced by 67% among HIV-positive people who took both isoniazid and HAART, while isoniazid on its own reduced the risk of the disease by 32%, and HAART alone reduced the risk of TB by 51%. The researchers also found that the combination is more beneficial among HIV-positive people with lower CD4+T cell counts. The combination reduced the risk of TB by 66% among HIV-positive people with T cell counts below 350, compared with a 56% risk reduction among HIV-positive people with higher T cell counts, according to the study. Chaisson said although the World Health Organization recommends isoniazid to prevent TB among HIV-positive people and the drug costs less than $1 for a full course of treatment, few physicians prescribe it. The researchers say they plan to continue monitoring the effectiveness of the drugs -- both as a combination therapy and as monotherapies -- at preventing the risk of TB among HIV-positive people in Rio de Janeiro. The research is part of three studies by the Bill & Melinda Gates Foundation-funded Consortium To Respond Effectively to the AIDS/TB Epidemic, which aims to develop new ways to detect and treat TB among HIV-positive people (Thom, Health-e News, 8/13).

Kaisernetwork.org is serving as the official webcaster of the conference. View the guide to coverage and all webcasts, interviews and a daily video round up of conference highlights at www.kaisernetwork.org/aids2006.

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