Empirical vs. Preventive Tuberculosis Treatment at ART Initiation in High TB Prevalence Settings

Among patients with advanced HIV disease in settings with high tuberculosis prevalence, starting empiric treatment for tuberculosis did not reduce mortality compared with isoniazid preventive therapy alone at ART initiation.

Tuberculosis (TB) is the most common cause of death in HIV-infected individuals initiating antiretroviral therapy (ART) in resource-limited settings. Therefore, empiric treatment for TB at the time of ART initiation in asymptomatic HIV-infected individuals living in settings with high TB prevalence has been suggested as an approach to reduce TB-associated mortality. The World Health Organization recommends that only isoniazid (preventive) therapy be initiated in this situation. To compare empiric TB treatment versus isoniazid therapy in people with advanced HIV initiating ART in settings where TB is common, researchers conducted the REMEMBER study. They enrolled 850 patients, primarily in sub-Saharan Africa, with CD4 count <50 cells/µL who …

Reviewing Author

Carlos del Rio, MD

Disclosures

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines

Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)

Carlos del Rio, MD

Disclosures

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines

Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)

Empirical vs. Preventive Tuberculosis Treatment at ART Initiation in High TB Prevalence Settings

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Reviewing Author