Drugs Found Effective for TB With HIV Infection

Tuberculosis patients co-infected with HIV have a new drug protocol

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Activities that require daily maintenance can be tough to adhere to. New research shows that patients with TB can take drugs less often and for a shorter duration of time.

Infectious disease experts from Johns Hopkins have developed a weekly medication protocol for tuberculosis (TB) patients who are also infected with HIV. Patients can now take their medication once a week for three months. The present protocol, which is less effective, requires a daily dose for six months.

"Tuberculosis may become easier to treat."

Lead study author, Richard Chaisson, M.D., a professor of infectious diseases at the Johns Hopkins University School of Medicine and founding director of the Center for Tuberculosis Research, reports that this very simple regimen with rifapentine (Priftin) and isoniazid (Nydrazid) is effective and could realistically transform therapy for patients with latent TB -- with or without HIV.

New treatment options are desperately needed in an attempt to control TB globally. The simpler the regimen, the more likely a larger number of people will stick with therapy. Dr. Chaisson wants people to know that fewer than one percent of those infected with TB are receiving any drug treatment due to inconvenience, side effects and an inability to find a clinic close to where they live.

The World Health Organization suggests that patients with TB receive Nydrazid, but physicans in South Africa are hesitant to prescribe it, according to Dr. Chaisson. Doctors fear producing drug-resistant bacteria and don't want to prescribe medications associated with drug toxicity and liver damage in people who also have HIV.

Chaisson says the new streamlined, weekly regimen makes it much easier for patients to comply, as evidenced by a 95 percent completion rate by study volunteers. The traditional daily-for-six-months Nydrazid therapy shows a compliance rate of about 60 percent or less in studies and clinical settings.

This is extremely important, Chaisson reports, because Nydrazid does not work if treatment is interrupted. Daily medicine compliance is much more difficult to sustain than a weekly regimen.

This latest study included 1,148 South African men and women co-infected with HIV. These results represent the most significant advance in preventing TB since Nydrazid was first proven effective in the 1950s. The international team of scientists found that the most streamlined combination is a high dose pairing of 900 milligrams each of Priftin, a newer antibiotic, and traditional Nydrazid once weekly for three months. This protocol worked just as well or better than 300 milligrams of Priftin taken daily for six months or longer.

These study results are published in The New England Journal of Medicine in July 2011.

Reviewed by: 
Review Date: 
July 7, 2011
Last Updated:
July 12, 2011