EFFECT OF ISONIAZID PROPHYLAXIS ON INCIDENCE OF ACTIVE TUBERCULOSIS AND PROGRESSION OF HIV-INFECTION
EFFECT OF ISONIAZID PROPHYLAXIS ON INCIDENCE OF ACTIVE TUBERCULOSIS AND PROGRESSION OF HIV-INFECTION
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DOI：
10.1016/0140-6736(93)91817-6
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发表时间：
1993-07-31
期刊：
影响因子：
168.9
通讯作者：
JOHNSON, WD
中科院分区：
文献类型：
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作者：
PAPE, JW;JEAN, SS;JOHNSON, WD
人类免疫缺陷病毒（HIV）感染引起的结核病是一个严重的和日益严重的公共卫生问题。我们在海地太子港进行了一项为期12个月的异烟肼加维生素B6与维生素B6单独治疗的随机临床试验，以评估异烟肼在预防无结核病的HIV感染者活动性结核病方面的疗效。预防对HIV疾病，艾滋病和死亡的发展的影响也进行了调查。118例受试者被分配与异烟肼加B6（n=58）或B6单独（n=60）在1986年和1989年之间的治疗。治疗组在进入研究时的人口统计学、临床和免疫学特征相似。1990年的中期分析显示，结核病结局指标无显著差异。随访一直持续到1992年，当时异烟肼对结核病的发展有明显的保护作用，无论是对整个研究人群还是对结核菌素纯化蛋白衍生物（PPD）阳性的受试者。结核病的发病率在异烟肼接受者比在接受B6单独（2.2比7.5每100人年）。单用B6与异烟肼加B6相比，结核病的相对危险度为3.4（95%CI 1.1-10.6）（p
Tuberculosis occurring with human immunodeficiency virus (HIV) infection is a serious and growing public health problem. We have carried out a randomised clinical trial of a 12-month course of isoniazid plus vitamin B6 versus vitamin B6 alone in Port-au-Prince, Haiti, to assess the efficacy of isoniazid in preventing active tuberculosis in symptom-free HIV-infected individuals. The effect of prophylaxis on the development of HIV disease, AIDS, and death was also investigated.118 subjects were assigned treatment with isoniazid plus B6 (n=58) or B6 alone (n=60) between 1986 and 1989. The treatment groups were similar at study entry in demographic, clinical, and immunological characteristics. Interim analysis in 1990 revealed no significant difference in tuberculosis outcome measures. Follow-up was continued until 1992, at which time significant protection by isoniazid against the development of tuberculosis was apparent, both for the whole study population and for subjects positive for purified protein derivative of tuberculin (PPD). The incidence of tuberculosis was lower in isoniazid recipients than in patients who received B6 alone (2.2 vs 7.5 per 100 person-years). The relative risk of tuberculosis was 3.4 (95% CI 1.1-10.6) for B6 alone versus isoniazid plus B6 (p