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© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

To tackle the tuberculosis (TB) epidemic, in 2014 the World Health Organization launched the End TB Strategy, which includes action to prevent latent TB infection (LTBI) reactivation. Available preventive treatments (PT) are based on either isoniazid (INH) alone or rifampicin (RIF)-containing regimens. This study aims to assess and compare PT completion rates, the occurrence of adverse events, and the time of dropout among those receiving INH-alone or RIF-containing regimens at Villa Marelli Institute, Milan, Italy, covering the period from 1992 to 2018. A total of 19,670 subjects, belonging to various risk groups—mainly young (median age of 29 years), foreign-born (73.3%), and males (58.8%)—with presumed LTBI were prescribed PT (79.3% INH-alone and 20.7% RIF-containing regimens). The treatment completion rate was 79.4% on average, with higher rates among those receiving RIF-containing regimens (85.6%) compared to those that were prescribed INH-alone (77.8%) (p < 0.0001). Notably, some of the high-risk groups for progression of LTBI were more likely to complete PT from RIF-containing regimens. These groups included recent TB contact (89.9%, p < 0.0001), healthcare workers (93.5%, p < 0.0001), and homeless people (76.6%, p < 0.0001). Irrespectively of the chosen PT regimen, most of the dropouts occurred between the start of the treatment and the first follow-up visit (14.3%, 15.2% for those on INH-alone vs. 11.1% for those on RIF-containing regimens). Further shortening of the PT regimen is therefore an aim to ensure adherence, even though it might need further efforts to enhance the patient’s attitude towards starting and carrying out PT.

Details

Title
Latent Tuberculosis Infection Treatment Completion while Shifting Prescription from Isoniazid-Only to Rifampicin-Containing Regimens: A Two-Decade Experience in Milan, Italy
Author
Villa, Simone 1   VIAFID ORCID Logo  ; Ferrarese, Maurizio 2 ; Sotgiu, Giovanni 3   VIAFID ORCID Logo  ; Castellotti, Paola Francesca 2 ; Saderi, Laura 4   VIAFID ORCID Logo  ; Grecchi, Cecilia 5 ; Saporiti, Matteo 2 ; Raviglione, Mario 6 ; Luigi Ruffo Codecasa 2 

 StopTB Italia Onlus, 20159 Milan, Italy 
 StopTB Italia Onlus, 20159 Milan, Italy; Regional TB Reference Centre, Villa Marelli Institute/ASST Niguarda, 20159 Milan, Italy 
 StopTB Italia Onlus, 20159 Milan, Italy; Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy 
 Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy 
 Infectious Diseases Unit, IRCCS San Matteo, 27100 Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy 
 StopTB Italia Onlus, 20159 Milan, Italy; Global Health Center, Multidisciplinary Research in Health Science University of Milan, 20122 Milan, Italy 
First page
101
Publication year
2020
Publication date
2020
Publisher
MDPI AG
e-ISSN
20770383
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2641154150
Copyright
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.