Latent tuberculosis infection treatment for prison inmates: A randomised controlled trial
Journal
International Journal of Tuberculosis and Lung Disease
Journal Volume
16
Journal Issue
5
Pages
633-638
Date Issued
2012
Author(s)
Chan P.-C.
Yang C.-H.
Wang K.-F.
Lu B.-Y.
Abstract
SETTING: A prison in northern Taiwan. OBJECTIVE: To compare safety and the completion rate of the 4-month daily rifampicin regimen (4R) vs. the standard 6-month daily isoniazid regimen (6H) for latent tuberculosis infection (LTBI) in prison inmates. DESIGN: This was an open-label randomised trial among human immunodeficiency virus negative male inmates. Inmates without active tuberculosis (TB) who tested positive for both the tuberculin skin test and QuantiFERON?-TB Gold In-Tube were eligible, but those with baseline glutamic pyruvic transaminase (GPT) levels ? 120 U/l, bilirubin levels ? 2.4 U/l or a platelet count < 150 k/mm 3were excluded. The primary endpoint was any adverse event that resulted in discontinuation of LTBI treatment. RESULTS: Participants (n = 373; 14% hepatitis B surface antigen positive, 21% anti-hepatitis C virus [HCV] positive) were randomised (stratified by hepatitis B virus, HCV status and 2-year prison term) to receive either 4R or 6H under directly observed treatment. The 4R group (n = 190) was less likely to experience an adverse event leading to discontinuation of treatment (2% vs. 12%, P < 0.001 for all adverse events; 0% vs. 8%, P < 0.001 for hepatotoxicity), and more likely to complete LTBI treatment (86% vs. 78%, P = 0.041), compared with the 6H group (n = 183). CONCLUSIONS: 4R is safer and has a higher completion rate than 6H as treatment for LTBI among male prison inmates. ? 2012 The Union.
SDGs
Other Subjects
alanine aminotransferase; bilirubin; hepatitis B surface antigen; hepatitis C antibody; isoniazid; rifampicin; tuberculin; adult; article; bilirubin blood level; blood analysis; controlled study; drug safety; drug withdrawal; hepatitis B; hepatitis C; human; liver toxicity; major clinical study; male; outcome assessment; prevalence; priority journal; prison; randomized controlled trial; risk factor; Taiwan; thorax radiography; tuberculin test; tuberculosis; Adolescent; Adult; Aged; Antitubercular Agents; Follow-Up Studies; Humans; Interferon-gamma Release Tests; Isoniazid; Latent Tuberculosis; Male; Medication Adherence; Middle Aged; Prisoners; Rifampin; Taiwan; Treatment Outcome; Tuberculin Test; Young Adult
Type
journal article