AI Article Synopsis
- Correctional facilities effectively treat latent tuberculosis infection (LTBI) using a 12-week regimen of isoniazid and rifapentine (INH-RPT), achieving a high completion rate of 92% among 463 inmates.
- Out of those who discontinued treatment (8%), the main reasons included clinical signs/symptoms (44%), transfers or releases (23%), treatment refusals (21%), and provider errors (13%), with fatigue and nausea being the most reported symptoms.
- Significant symptoms linked to treatment discontinuation included abdominal pain and appetite loss, suggesting that while the completion rates are generally high, certain side effects still need monitoring and management.
Article Abstract
Context: Correctional facilities provide unique opportunities to diagnose and treat persons with latent tuberculosis infection (LTBI). Studies have shown that 12 weekly doses of isoniazid and rifapentine (INH-RPT) to treat LTBI resulted in high completion rates with good tolerability.
Objective: To evaluate completion rates and clinical signs or reported symptoms associated with discontinuation of 12 weekly doses of INH-RPT for LTBI treatment.
Setting/participants: During July 2012 to February 2015, 7 Federal Bureau of Prisons facilities participated in an assessment of 12 weekly doses of INH-RPT for LTBI treatment among 463 inmates.
Main Outcome Measures: Fisher exact test was used to assess the associations between patient sociodemographic characteristics and clinical signs or symptoms with discontinuation of treatment.
Results: Of 463 inmates treated with INH-RPT, 424 (92%) completed treatment. Reasons for discontinuation of treatment for 39 (8%) inmates included the following: 17 (44%) signs/symptoms, 9 (23%) transfer or release, 8 (21%) treatment refusal, and 5 (13%) provider error. A total of 229 (49.5%) inmates reported experiencing at least 1 sign or symptom during treatment; most frequently reported were fatigue (16%), nausea (13%), and abdominal pain (7%). Among these 229 inmates, signs/symptoms significantly associated with discontinuation of treatment included abdominal pain (P < .001), appetite loss (P = .02), fever/chills (P = .01), nausea (P = .03), sore muscles (P = .002), and elevation of liver transaminases 5× upper limits of normal or greater (P = .03).
Conclusions: The LTBI completion rates were high for the INH-RPT regimen, with few inmates discontinuing because of signs or symptoms related to treatment. This regimen also has practical advantages to aid in treatment completion in the correctional setting and can be considered a viable alternative to standard LTBI regimens.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336524 | PMC |
| http://dx.doi.org/10.1097/PHH.0000000000000822 | DOI Listing |
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