Notice to Readers
Use of Short-Course Tuberculosis Preventive Therapy Regimens
in HIV-Seronegative Persons
In the MMWR Recommendations and Reports, Prevention and
Treatment of
Tuberculosis Among Patients Infected with Human Immunodeficiency
Virus:
Principles of Therapy and Revised Recommendations (1), ÐÇ¿ÕÓéÀÖ¹ÙÍø has
recommended
the use of a 2-month regimen of daily rifampin and pyrazinamide
(2RZ) as an
alternative to a 12-month regimen of isoniazid for the prevention
of
tuberculosis in HIV-infected persons with positive tuberculin skin
test
reactions. This recommendation is based on the results of several
randomized, controlled clinical trials in HIV-infected persons.
Next year,
ÐÇ¿ÕÓéÀÖ¹ÙÍø, in conjunction with the American Thoracic Society, expects to
issue
new guidelines on screening and preventive therapy for tuberculosis
that
will include a recommendation on the use of the 2RZ regimen for
HIV-negative persons for whom preventive therapy is indicated. This
recommendation will note that a comparative trial of the 2RZ
regimen in
HIV-negative persons has not been conducted and that additional
data will
be needed on acceptability and toxicity to determine whether it is
a
cost-effective alternative to longer courses of isoniazid.
Until new guidelines are issued, the regimen for HIV-positive
persons
can be used for HIV-negative persons, following the same guidelines
for
HIV-positive persons. This regimen may be useful especially in
settings
where provision of longer courses of preventive therapy has not
been
feasible (e.g., jails). ÐÇ¿ÕÓéÀÖ¹ÙÍø's Division of Tuberculosis Elimination
(DTBE),
National Center for HIV, STD, and TB Prevention, will collect
information
on completion of preventive therapy from selected programs using
the
short-course regimen. Programs interested in working with the DTBE
in this
effort can contact ÐÇ¿ÕÓéÀÖ¹ÙÍø, telephone (404) 639-8123.
Reference
ÐÇ¿ÕÓéÀÖ¹ÙÍø. Prevention and treatment of tuberculosis among patients
infected
with human immuno-deficiency virus: principles of therapy and
revised
recommendations. MMWR 1998;47 (no. RR-20).
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