Three Months of Rifapentine and Isoniazid for Latent Tuberculosis Infection

• Published in: The New England journal of medicine Vol. 365; no. 23; pp. 2155 - 2166
• Main Authors: Sterling, Timothy R, Villarino, M. Elsa, Borisov, Andrey S, Shang, Nong, Gordin, Fred, Bliven-Sizemore, Erin, Hackman, Judith, Hamilton, Carol Dukes, Menzies, Dick, Kerrigan, Amy, Weis, Stephen E, Weiner, Marc, Wing, Diane, Conde, Marcus B, Bozeman, Lorna, Horsburgh, C. Robert, Chaisson, Richard E
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 08-12-2011
• Subjects: Adult; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antitubercular Agents - administration & dosage; Antitubercular Agents - adverse effects; Bacterial diseases; Biological and medical sciences; Directly Observed Therapy; Drug Administration Schedule; Drug Therapy, Combination; Follow-Up Studies; General aspects; Hepatotoxicity; HIV; Human bacterial diseases; Human immunodeficiency virus; Humans; Infections; Infectious diseases; Intention to Treat Analysis; Isoniazid; Isoniazid - administration & dosage; Isoniazid - adverse effects; Male; Medical sciences; Middle Aged; Motivation; Pharmacology. Drug treatments; Prospective Studies; Rifampin - administration & dosage; Rifampin - adverse effects; Rifampin - analogs & derivatives; Risk Factors; Self Administration; Skin; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis - prevention & control; Tuberculosis and atypical mycobacterial infections; Virus Latency; Infection; Medicine; Antituberculous agent; Antibacterial agent; Isoniazid; Rifapentine
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1104875

Treatment of latent TB is an important public-health strategy, but 9 months of daily isoniazid (270 doses) poses challenges for compliance. In this study, 3 months of weekly isoniazid plus rifapentine (12 doses) was found to be noninferior to 9 months of isoniazid alone.
Tuberculosis results in nearly 2 million deaths annually worldwide.
1
More than 2 billion persons are infected with
Mycobacterium tuberculosis,
2
and from this reservoir active tuberculosis will develop in millions of persons in coming decades. Treatment of latent
M. tuberculosis
infection among the persons at highest risk for progression to active disease is an important strategy for tuberculosis control and elimination.
3
–
6
The current standard regimen for the treatment of latent
M. tuberculosis
infection is 9 months of daily isoniazid.
3
The efficacy for isoniazid was found to be 69 to 93% in a study that was published in 1982 (before the . . .