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The WHO currently recommends a 6-month course of isoniazid preventative therapy for HIV-infected individuals who have a positive tuberculin skin test or are living in areas where skin testing is not feasible and the prevalence of latent tuberculosis (TB) exceeds 30%. However, recent studies conducted in Africa have suggested that prophylaxis for longer than 6 months may be needed in TB-endemic regions.
To examine this possibility, researchers conducted a double-blind trial among HIV-infected adults in Botswana, where TB is endemic and HIV treatment is free. The 1995 enrollees were randomized to receive 36 months of isoniazid prophylaxis (continued isoniazid group) or 6 months of isoniazid followed by 30 months of placebo (control group). Ant…