Completion of isoniazid–rifapentine (3HP) for tuberculosis prevention among people living with HIV: Interim analysis of a hybrid type 3 effectiveness–implementation randomized trial

PLoS MedicineSemitala FC, Kadota JL, Musinguzi A, et al. | January 10, 2022

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For preventing tuberculosis (TB) among people living with HIV (PLHIV), the World Health Organization (WHO) has recently recommended administration of short course (12 weeks) isoniazid–rifapentine (3HP). Considering the relevance of evidence of successful implementation for informing country-level decisions to scale up 3HP, researchers herein aimed to retrieve data on 3HP patient acceptance and completion in the context of routine HIV care in sub-Saharan Africa.

  • A total of 479 participants in an ongoing randomized trial of 3 strategies for 3HP delivery taking place at a large, urban HIV/AIDS clinic in Kampala, Uganda, were assessed in this interim analysis.

  • Routine healthcare providers performed all aspects of 3HP treatment—including counseling, drug administration, side effect monitoring, and adherence evaluation.

  • There was a high acceptance and completion of 3HP (93%, with >99% probability of exceeding 80% in at least 1 trial arm).

  • 3HP treatment was discontinued in only 8 (1.7%) patients due to an adverse event (AE).

  • Findings overall suggest the possibility of achieving high levels of 3HP acceptance and completion in the context of routine HIV/AIDS care in sub-Saharan Africa.

  • Consideration should be given to scaling up 3HP as an alternative to isoniazid preventive therapy in HIV/AIDS programs in sub-Saharan Africa.

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