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High prevalences of TB and HIV infection often coexist in a given population; in coinfected individuals, the two infections worsen each other. Previous studies have shown the efficacy of isoniazid (INH) prophylaxis in preventing TB in HIV-infected adults with positive tuberculin skin-test results. Might this strategy work for children, too?
In a two-center, prospective, randomized, double-blind study, researchers in South Africa treated 263 HIV-infected children ≥8 weeks old (median age, 24.7 months) with trimethoprim-sulfamethoxazole plus either INH or placebo. CD4-cell counts and TB testing were performed upon enrollment and thereafter at 6-month intervals. Duration of prophylaxis was planned for 2 years, but the placebo arm was stopped af…