Debunking the myths perpetuating low implementation of isoniazid preventive therapy amongst human immunodeficiency virus-infected persons

• 作者: Christopher Akolo Eno Usoroh Evaezi Okpokoro Florence Bada Michael Odo Ogochukwu Nwanne Olanrewaju Oladimeji Sharon Iziduh Taofeekat Ali Vivian Ibeziako
• 来源期刊: 世界病毒学杂志
• 学科: 医学
• 关键词: Human IMMUNODEFICIENCY virus ISONIAZID PREVENTIVE therapy Tuberculosis CHEMOPROPHYLAXIS
• 年，卷（期）: 2015,（2）
• 页码范围: 105-112
• 页数: 8页
• 分类号: R

摘要

Isoniazid preventive therapy(IPT)is the administration of isoniazid(INH)to people with latent tuberculosis(TB)infection(LTBI)to prevent progression to active TB disease.Despite being life-saving for human immunodeficiency virus(HIV)-infected persons who do not have active TB,IPT is poorly implemented globally due to misconceptions shared by healthcare providers and policy makers.However,amongst HIV-infected patients especially those living in resource-limited settings with a high burden of TB,available evidence speaks for IPT:Among HIV-infected persons,active TB-the major contraindication to IPT,can be excluded with symptom screening;chest X-ray and tuberculin skin testing are unreliable and often lead to logistic delays resulting in increased numbers of people with LTBI progressing to active TB;the use of IPT has not been found to increase the risk of the development of INH mono-resistance;IPT is cost-effective and cheaper than the cost of treating cases of active TB that would develop without IPT;ART and IPT have an additive effect on the prevention of TB,and both are safe and beneficial even in children.In order to sustain the recorded gains from ART scale-up and to further reduce TB-related morbidity and mortality,more efforts are needed to scale-up IPT implementation globally.