HIV: The benefits of prophylaxis of tuberculosis are confirmed

October 11, 2017, ANRS

A long-term follow-up study in the ANRS TEMPRANO trial confirms that tuberculosis chemoprophylaxis in HIV-infected people is more than ever relevant in resource-limited countries. This prophylactic use of drugs reduces mortality, even among people taking antiretroviral treatment who have a high CD4+ T cell count. ANRS TEMPRANO was conducted by researchers of the Ivory Coast ANRS site, which comprises teams from Inserm (U1219, University of Bordeaux), the Infectious and Tropical Diseases Department of the Treichville University Hospital, and eight other infection treatment centers in Abidjan. The results of this trial will be published in the 9 October 2017 issue of The Lancet Global Health and should encourage countries with a heavy tuberculosis burden to apply the relevant WHO recommendations.

Tuberculosis is the leading cause of death among HIV-infected people in sub-Saharan Africa. In the 1990s, several studies showed that HIV-infected people who take the antibiotic isoniazid for six to 12 months are at lower risk of developing . On the basis of these studies, since 1993, the WHO has recommended that people living with HIV in countries where tuberculosis is rife should take isoniazid for six months. However, this recommendation is seldom applied because it was deemed obsolete following the advent of antiretrovirals that restore immunity and hence lower the risk of tuberculosis. ANRS TEMPRANO has reassessed the benefits of isoniazid prophylaxis in the era of early .

ANRS TEMPRANO was conducted between 2008 and 2015, and showed that six-month isoniazid prophylaxis for tuberculosis and early antiretroviral treatment both reduced the risk of severe morbidity in the first two years of follow-up. Published in the New England Journal of Medicine in 2015, these results greatly contributed to the formulation of WHO treatment recommendations. ANRS TEMPRANO participants were then followed up for an average of 4.5 years, and the findings are now published in The Lancet Global Health. This long-term follow-up shows that tuberculosis chemoprophylaxis reduces not only severe morbidity, but also mortality, and that this benefit, which is independent of and complementary to that of antiretroviral , lasts at least six years after administration.

Professor François Dabis, the Director of the ANRS, says, "We now have irrefutable evidence of the value of tuberculosis chemoprophylaxis in HIV-infected people in resource-limited countries in the era of antiretrovirals, even when these are initiated very early. The WHO recommendations should more than ever be applied."

Explore further: HIV: A therapeutic advance for resource-limited settings

More information: Badje A, Moh R, Gabillard D, et al. Effect of isoniazid preventive therapy on risk of death in west African HIV-infected adults with high CD4 count: long-term follow up of the Temprano ANRS 12136 trial. Lancet Glob Health 2017; 5: e1080-89

Related Stories

HIV: A therapeutic advance for resource-limited settings

May 29, 2017
ANRS 12286 MOBIDIP, a clinical trial running in parallel in three countries in sub-Saharan Africa (Cameroon, Burkina Faso, and Senegal), shows that dual therapy with lamivudine and a boosted protease inhibitor is effective ...

Updated review confirms efficacy and safety of most standard treatments for latent tuberculosis infection

July 31, 2017
Robust evidence confirms that most standard treatment regimens currently recommended by the World Health Organization and the Centers for Disease Control and Prevention for latent tuberculosis infection (LTBI), including ...

Assay can ID M. tuberculosis resistance mutations

September 15, 2017
(HealthDay)—An automated molecular assay can detect Mycobacterium tuberculosis with resistance to drugs directly from sputum specimens, according to a study published in the Sept. 14 issue of the New England Journal of ...

Common treatment of TB in advanced HIV patients doesn't save more lives

March 17, 2016
In a report on the so-called REMEMBER (Reducing Early Mortality and Early Morbidity by Empiric Tuberculosis Treatment) study—a 10-nation, randomized clinical trial of adult outpatients—investigators concluded that there ...

Shorter Combination treatment as effective as monotherapy for TB prevention in kids

January 12, 2015
To prevent tuberculosis (TB) in children with latent tuberculosis infection (which is not active but can become active), combination treatment with the medications rifapentine and isoniazid was as effective as longer treatment ...

Tuberculosis vaccine safe for teens with Schistosoma parasite

May 4, 2017
Of the millions of people at risk for contracting tuberculosis each year, many are already infected with helminths, parasitic worms including Schistosoma flatworms. In some cases, parasite infections can impair the ability ...

Recommended for you

Deadly Rift Valley fever: New insight, and hope for the future

July 19, 2018
Health control measures alone could be ineffective in the long term fight against the deadly Rift Valley fever which affects both humans and animals, a new study in the journal PNAS reports.

Yeast species used in food industry causes disease in humans

July 19, 2018
A major cause of drug-resistant clinical yeast infections is the same species previously regarded as non-pathogenic and commonly used in the biotechnology and food industries. The study, published on July 19th in the open-access ...

New guidelines to diagnose, manage rare endocrine disorders

July 19, 2018
International guidelines have been published for the first time to help doctors around the globe diagnose and manage patients with a very rare set of endocrine diseases known as pseudohypoparathyroidism and its related disorders, ...

Overuse of antibiotics not what the doctor ordered

July 19, 2018
With increased use of antibiotics worldwide linked to growing antibiotic resistance, a world-first study co-authored by a QUT researcher has highlighted the growing impact of non-prescription supply of antibiotics in community ...

Alcohol-related cirrhosis deaths skyrocket in young adults

July 18, 2018
Deaths from cirrhosis rose in all but one state between 1999-2016, with increases seen most often among young adults, a new study shows.

Childhood abuse linked to greater risk of endometriosis, study finds

July 17, 2018
Endometriosis, a painful condition that affects one in 10 reproductive-age women in the U.S., has been linked to childhood physical and sexual abuse, according to findings published today in the journal Human Reproduction.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.