CROI 2019: Two “game changing regimens” together show promise for preventing TB in people living with HIV

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Science Speaks is in Seattle this week covering breaking news in HIV research, policies and plans at CROI 2019 March 4-7.

SEATTLE – A new and shorter drug regimen to prevent tuberculosis illness can safely be given to people with HIV who are on antiretroviral treatment regimens that include dolutegravir, researchers here announced. The finding is good news for people living with HIV for two reasons.

The new regimen – consisting of the TB drugs isoniazid and rifapentine  – treats the inactive form of TB infection before it can cause illness in people living with HIV taken once a week for three months – a big improvement over the standard regimen that requires taking pills every day for six months. Rifapentine, however, is known to reduce concentrations of other drugs when taken concurrently, complicating access to the preventive TB regimen for people on most antiretroviral treatment regimens. In addition, leading to viral suppression faster, fewer side effects and less risk of resistance, dolutegravir is a widely preferred drug in any case.

The findings may pave the way for accelerating efforts to combat TB infection among people living with HIV, Kelly Dooley of Johns Hopkins University said, as TB remains the biggest killer of people infected with HIV.

Researchers provided the standard dose of dolutegravir to 60 study participants for two months, followed by three months of once-weekly rifapentine and isoniazid, and found that while dolutegravir concentration was slightly reduced, there was no change in viral load suppression one month after the completion of TB treatment when compared to baseline levels, researchers said. Researchers did not have to increase the dose of dolutegravir to maintain viral suppression.

“We now know that it’s safe to take these two game-changing regimens together.” Dr. Dooley said.

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