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Treatment for Tuberculosis Infection With 3 Months of Isoniazid and Rifapentine in New York City Health Department Clinics.
Clin Infect Dis. 2016 Jan 01; 62(1):53-59.CI

Abstract

BACKGROUND

Completion of treatment for tuberculosis infection (TBI) with 9 months of self-administered daily isoniazid (9H) has historically been low (<50%) among New York City (NYC) Health Department tuberculosis clinic patients. Treatment of TBI with 3 months of once-weekly isoniazid and rifapentine (3HP) administered under directly observed therapy (DOT) might increase treatment acceptance and completion.

METHODS

The study population included patients diagnosed with TBI at 2 NYC Health Department tuberculosis clinics from January 2013 through November 2013. Treatment acceptance and completion with 3HP were compared with historical estimates. Treatment outcomes, side effects, and reasons for refusing 3HP were described.

RESULTS

Among 631 patients eligible for TBI treatment, 503 (80%) were offered 3HP; 302 (60%) accepted, 92 (18%) chose other treatment, and 109 (22%) refused treatment. The most common reason for refusing 3HP was the clinic-based DOT requirement. Forty (13%) patients treated with 3HP experienced side effects--9 were restarted on 3HP, 18 switched treatment regimens, and 13 discontinued. Although treatment acceptance did not differ from historical estimates (78% vs 79%, P = .75), treatment completion increased significantly (65% vs 34%, P < .01).

CONCLUSIONS

Implementation of 3HP in 2 NYC Health Department tuberculosis clinics increased TBI treatment completion by 31 percentage points compared with historical estimates. More flexible DOT options may improve acceptance of 3HP. Wider use of 3HP may substantially improve TBI treatment completion in NYC and advance progress toward tuberculosis elimination.

Authors+Show Affiliations

New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, Long Island City, New York.New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, Long Island City, New York.New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, Long Island City, New York.New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, Long Island City, New York.New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, Long Island City, New York.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26338781

Citation

Stennis, Natalie L., et al. "Treatment for Tuberculosis Infection With 3 Months of Isoniazid and Rifapentine in New York City Health Department Clinics." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 62, no. 1, 2016, pp. 53-59.
Stennis NL, Burzynski JN, Herbert C, et al. Treatment for Tuberculosis Infection With 3 Months of Isoniazid and Rifapentine in New York City Health Department Clinics. Clin Infect Dis. 2016;62(1):53-59.
Stennis, N. L., Burzynski, J. N., Herbert, C., Nilsen, D., & Macaraig, M. (2016). Treatment for Tuberculosis Infection With 3 Months of Isoniazid and Rifapentine in New York City Health Department Clinics. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 62(1), 53-59. https://doi.org/10.1093/cid/civ766
Stennis NL, et al. Treatment for Tuberculosis Infection With 3 Months of Isoniazid and Rifapentine in New York City Health Department Clinics. Clin Infect Dis. 2016 Jan 1;62(1):53-59. PubMed PMID: 26338781.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment for Tuberculosis Infection With 3 Months of Isoniazid and Rifapentine in New York City Health Department Clinics. AU - Stennis,Natalie L, AU - Burzynski,Joseph N, AU - Herbert,Cheryl, AU - Nilsen,Diana, AU - Macaraig,Michelle, Y1 - 2015/09/03/ PY - 2015/05/15/received PY - 2015/08/19/accepted PY - 2015/9/5/entrez PY - 2015/9/5/pubmed PY - 2016/9/20/medline KW - 3-month treatment KW - directly observed therapy KW - latent tuberculosis infection KW - public health SP - 53 EP - 59 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 62 IS - 1 N2 - BACKGROUND: Completion of treatment for tuberculosis infection (TBI) with 9 months of self-administered daily isoniazid (9H) has historically been low (<50%) among New York City (NYC) Health Department tuberculosis clinic patients. Treatment of TBI with 3 months of once-weekly isoniazid and rifapentine (3HP) administered under directly observed therapy (DOT) might increase treatment acceptance and completion. METHODS: The study population included patients diagnosed with TBI at 2 NYC Health Department tuberculosis clinics from January 2013 through November 2013. Treatment acceptance and completion with 3HP were compared with historical estimates. Treatment outcomes, side effects, and reasons for refusing 3HP were described. RESULTS: Among 631 patients eligible for TBI treatment, 503 (80%) were offered 3HP; 302 (60%) accepted, 92 (18%) chose other treatment, and 109 (22%) refused treatment. The most common reason for refusing 3HP was the clinic-based DOT requirement. Forty (13%) patients treated with 3HP experienced side effects--9 were restarted on 3HP, 18 switched treatment regimens, and 13 discontinued. Although treatment acceptance did not differ from historical estimates (78% vs 79%, P = .75), treatment completion increased significantly (65% vs 34%, P < .01). CONCLUSIONS: Implementation of 3HP in 2 NYC Health Department tuberculosis clinics increased TBI treatment completion by 31 percentage points compared with historical estimates. More flexible DOT options may improve acceptance of 3HP. Wider use of 3HP may substantially improve TBI treatment completion in NYC and advance progress toward tuberculosis elimination. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/26338781/Treatment_for_Tuberculosis_Infection_With_3_Months_of_Isoniazid_and_Rifapentine_in_New_York_City_Health_Department_Clinics_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/civ766 DB - PRIME DP - Unbound Medicine ER -