Does Pre-Exposure Isoniazid Protect Against TB in HIV-Exposed Children?

In a randomized trial, a 96-week course of isoniazid pre-exposure prophylaxis had no effect on TB-free survival in either HIV-infected infants or infants who were HIV exposed but uninfected.

Previous studies have shown that isoniazid is effective in preventing tuberculosis (TB) among children already exposed to individuals with infectious TB. Is it also effective among children as pre-exposure prophylaxis?

Researchers recently addressed this question in a double-blind trial involving two cohorts of high-risk children in South Africa and Botswana. One cohort consisted of 547 HIV-infected infants; the other, 804 infants who were HIV exposed but uninfected. All the infants received bacille Calmette-Guérin vaccine within 30 days of birth and oral cotrimoxazole as per WHO recommendations. They were randomly assigned, within their respective cohorts, to receive either daily isoniazid (10–20 mg per kg of body weight) or placebo for 96 …

Reviewing Author

Salim S. Abdool Karim, MD, PhD

Disclosures

Consultant/Advisory BoardUNAIDS; WHO; Bill and Melinda Gates Foundation, Population Council

Grant/Research SupportNIH; National Institute of Allergy and Infectious Diseases; Tides Foundation/MAC AIDS Fund; USAID; South African National Research Foundation; European Union; South African Medical Research Council

Editorial BoardsNew England Journal of Medicine; AIDS Reviews; AIDS Research and Human Retroviruses; mBio; Indian Journal of Medical Research; JAIDS: Journal of Acquired Immune Deficiency Syndromes

Salim S. Abdool Karim, MD, PhD

Disclosures

Consultant/Advisory BoardUNAIDS; WHO; Bill and Melinda Gates Foundation, Population Council

Editorial BoardsNew England Journal of Medicine; AIDS Reviews; AIDS Research and Human Retroviruses; mBio; Indian Journal of Medical Research; JAIDS: Journal of Acquired Immune Deficiency Syndromes

Does Pre-Exposure Isoniazid Protect Against TB in HIV-Exposed Children?

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Reviewing Author