CROI 2017: More evidence that TB preventive therapy saves lives of people with HIV highlights need for policies

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Science Speaks is covering the 2017 Conference on Retroviruses and Opportunistic Infections in Seattle Washington live this week, from February 13-16, with breaking news on HIV research findings and implications.

SEATTLE – At CROI 2015 the results of the TEMPRANO trial showed that early initiation of antiretroviral therapy and six months of isoniazid preventive therapy significantly reduced illness including tuberculosis in patients with HIV.  On Wednesday, Anani Badje from the TEMPRANO group provided long-term follow-up results from this same study that confirmed the value of TB preventive therapy in reducing the risk of death among HIV patients. The results included those in earlier stages of HIV disease progression, independent of antiretroviral therapy. More than 2,000 patients in Cote d’ Ivoire who agreed to participate in this post-trial phase study were monitored for at least 30 months. About 90 percent of the participants, regardless of whether they received TB preventive therapy, were on antiretroviral treatment and received their free care in public facilities. Most patients had immune cell — or CD 4 — counts in the range of 500 per milliter of blood.

Of all the patients, 86 died, 34 in the group that received TB preventive therapy and 52 among those who did not. This translates into a 39 percent reduced risk of death with TB preventive therapy. The numbers of patients who were lost to follow-up were similar for both groups.

Badje noted that 24 years have passed since the World Health Organization first recommended TB preventive therapy for people living with HIV in high TB burden settings. He said later that he doesn’t know and yet use of this intervention remains low, “But I think we need to have strong and clear policies asking for implementation.” The results, he said argue for the provision of TB preventive therapy for all patients living with HIV, regardless of immune status.

 

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