Optimizing Tuberculosis Preventive Therapy for Persons with HIV

Tuberculosis (TB) continues to be a common comorbidity among persons with HIV, particularly in high-burden countries. While preventive therapy reduces risk for TB, worldwide adoption and scale-up have been poor. In a study conducted in three African countries, investigators randomized participants to one of three groups: weekly rifapentine and isoniazid for 3 months given annually for 2 years or given once, or 6 months of daily isoniazid. Of 4994 persons with HIV without symptoms compatible with tuberculosis and on an efavirenz-based antiretroviral therapy who were offered enrollment, 4027 were randomized (median age, 41; 69% female; 18% with CD4 count <250 cells/µL; 38% with a positive QuantiFERON-TB Gold Plus test).

Treatment completion wa…