Isoniazid therapy for Mycobacterium tuberculosis infection in HIV clinics, Los Angeles, California

• Published in: The international journal of tuberculosis and lung disease Vol. 20; no. 7; pp. 961 - 966
• Main Authors: Shin, S. S., Chang, A. H., Ghosh, J. K. C., Dubé, M. P., Bolan, R., Yang, O. O., Kerndt, P. R.
• Format: Journal Article
• Language: English
• Published: France International Union Against Tuberculosis and Lung Disease 01-07-2016
• Subjects: Adult; Ambulatory Care Facilities; Antitubercular Agents - therapeutic use; Coinfection; Cross-Sectional Studies; Female; Guideline Adherence; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - virology; HIV-1 - isolation & purification; HIV-TB co-infection; Humans; Isoniazid - therapeutic use; isoniazid preventive therapy; Latent Tuberculous Infection; Los Angeles - epidemiology; Male; Medication Adherence; Middle Aged; Practice Guidelines as Topic; Practice Patterns, Physicians; Public Sector; Retrospective Studies; Time Factors; Treatment Outcome; Tuberculosis - diagnosis; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis Elimination; Tuberculosis Prevention
• DOI: 10.5588/ijtld.15.0988
• EISSN: 1815-7920
• ISSN: 1027-3719

SETTING: Publicly funded human immunodeficiency virus (HIV) clinics in Los Angeles County, California, USA.BACKGROUND: HIV-infected persons are a high priority group for targeted testing and treatment for Mycobacterium tuberculosis infection in the United States.OBJECTIVE:
To describe rates of isoniazid (INH) initiation and completion among HIV-1 and M. tuberculosis co-infected persons in Los Angeles County.DESIGN: We conducted a cross-sectional study using routinely collected surveillance data from publicly funded HIV clinics. We examined differences
in INH treatment initiation and completion between four clinic categories: the three largest clinics (Clinics A, B, and C) and 'Other' clinics (pooled data for the remaining 10 clinics).RESULTS: During 2010-2013, 802 (5.3%) of 15 029 HIV-1-infected persons tested positive
for M. tuberculosis infection. INH was initiated in 581 (72.4%) persons, of whom 457 (78.7%) completed treatment. We found significant differences between clinics in terms of treatment initiation (range 59.1-93.4%) and completion (range 58.8-82.3%). Overall, 57% (457/802)
of HIV and M. tuberculosis co-infected persons completed the recommended treatment (range across clinics 34.8-76.3%).CONCLUSION: We identified significant gaps in the treatment for M. tuberculosis infection among HIV-infected persons in Los Angeles County. Interventions
are needed to improve initiation and completion of treatment for M. tuberculosis infection in this population.