Short-Course TB Prophylaxis Effective In HIV-Infected Individuals

A two-month course of therapy to prevent active tuberculosis (TB) is an effective alternative to the year-long regimen currently prescribed for persons co-infected with HIV and TB bacteria, a five-year international study has found.

The study, sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), the Centers for Disease Control and Prevention (CDC), and the Pan American Health Organization (PAHO), holds promise for reducing HIV-related TB disease and death in the United States and throughout the world.

"This is an important finding that could have a very positive impact on the health of persons infected with both HIV and TB," says NIAID Director Anthony S. Fauci, M.D. "TB and HIV are synergistic infections -- HIV infection speeds the progression of TB disease and increases the rate of activation of latent TB infection. TB appears to increase HIV replication in HIV-infected individuals." The World Health Organization (WHO) estimates that more than 5 million people worldwide are co-infected with HIV and TB, and approximately one-third of all HIV-related deaths worldwide are caused by TB.

Study Chair Fred Gordin, M.D., of the Veterans Affairs Medical Center in Washington, D.C., presented preliminary results of the short-course prevention study last week at the 5th Conference on Retroviruses and Opportunistic Infections in Chicago, Ill. He also will present the findings at a meeting of TB researchers scheduled for Feb. 18-20, 1998, at WHO headquarters in Geneva, Switzerland.

Nearly 1,600 HIV-infected people participated in the study, a randomized trial comparing two months of daily rifampin (RIF) and pyrazinamide (PZA) with 12 months of daily isoniazid

Contact: John Bowersox
NIH/National Institute of Allergy and Infectious Diseases

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