Primary Prevention and Treatment of Latent Tuberculosis Infection With Isoniazid: Efficacy of a Control Program, 1997-2002

• Published in: Archivos de bronconeumología (English ed.) 2005, Vol.41 (1), p.27-33
• Main Authors: Martínez Sanchís, A., Calpe Calpe, J.L., Llavador Ros, G., Ena Muñoz, J., Calpe Armero, A.
• Format: Article
• Language: English
• Subjects: Chemoprophylaxis; Contact study; Estudio de contactos; Hepatotoxicidad; Infección tuberculosa latente; Isoniacida; Isoniazid; Latent tuberculosis infection; Liver toxicity; Quimioprofilaxis
• ISSN: 1579-2129; 1579-2129
• DOI: 10.1016/S1579-2129(06)60391-1

To analyze the efficacy of a specific program for the study and follow up of tuberculosis contacts. To study factors related to low adherence to treatment and to the development of liver toxicity caused by isoniazid. Between December 1996 and December 2002, we found 458 contacts of 79 cases of pulmonary tuberculosis in patients uninfected by human immunodeficiency virus. The contacts were screened for tuberculosis infection and chemoprophylaxis was prescribed according to the recommendations of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). We identified 3 cases of tuberculosis among the contacts (prevalence 0.8%). Chemoprophylaxis with isoniazid was prescribed for 215 contacts. One hundred sixty-nine (79%) completed the prophylaxis protocol. The rate of adherence to treatment was lower in immigrants than in nonimmigrants (odds ratio, 3.42; 95% confidence interval, 1.03-11.04; P=.02). Forty-three patients (22%) developed liver toxicity during treatment, which had to be suspended in 3 cases. Duration of chemoprophylaxis was the only independent variable associated with liver toxicity (odds ratio, 3.80; 95% confidence interval, 1.10-13.13; P=.03). Our study demonstrates the effectiveness of a specific program of study and follow up of tuberculosis contacts. Immigrants require tailored strategies to improve their adherence to the program. The duration of chemoprophylaxis plays an important role in the development of liver toxicity. Analizar la eficacia de un programa específico para el estudio y seguimiento de los contactos de los pacien-tes con tuberculosis. Evaluar los factores relacionados con una baja adherencia al tratamiento y con el desarrollo de to-xicidad hepática por isoniacida. Entre diciembre de 1996 y diciembre de 2002 se censaron 458 contactos de 79 casos de tuberculosis pulmonar en pacientes sin infección por el virus de la inmunodeficiencia humana. Se realizó cribado de infección tuberculosa y se indicó quimioprofilaxis según la normativa vigente de la Sociedad Española de Neumología y Cirugía Torácica. Encontramos 3 casos de tuberculosis entre los contactos (prevalencia del 0,8%). Se indicó quimioprofilaxis con isoniacida en 215 casos. Un total de 169 (79%) completaron el protocolo de quimioprofilaxis. Los inmi-grantes mostraron baja adherencia al tratamiento frente a los que no lo eran ( odds ratio = 3,42; intervalo de confianza del 95%, 1,03-11,04; p = 0,02). Cuarenta y tres (22%) pacientes presentaron toxicidad hepática d