Latent tuberculosis is present in a quarter of the global population, and 10 percent of infected people will develop active TB, but new studies from the Research-Institute of the McGill University Health Centre (RI-MUHC) show that shorter course of treatment timelines with a different drug are safer and more effective in both adults and children.
The findings, published in the New England Journal of Medicine, followed 6,800 adults and 850 children in nine countries. They included Benin, Ghana and Guinea, where the researchers compared results among latent TB patients who underwent the current standard treatment of nine months of isoniazid (INH) or a four-month treatment with rifampin.
Rifampin therapy was much better with significantly fewer serious side effects, while delivering lower rates of development of active TB. That’s especially significant across Africa, where a 2017 study found latent TB rates as high as 55 percent in South Africa, 49 percent in Uganda and 31 percent in Ethiopia, with particular concern for high-risk groups including miners and health workers.
Reducing the latent TB rate and risk of transmission, and improving treatment access, are World Health Organization priorities.
“This four-month therapy is a fundamental game-changer in TB prevention,” said study leader Dr. Dick Menzies, who is a respirologist with MUHC and a professor of Medicine, Epidemiology and Biostatistics at McGill. “The four month treatment was as effective in preventing TB, safer and more acceptable. We believe this four month rifampin treatment should replace the nine months on INH for most people who need therapy for latent TB.”
Image: AAFP file