1. Isoniazid therapy for Mycobacterium tuberculosis infection in HIV clinics, Los Angeles, California
- Author
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Shin, SS, Chang, AH, Ghosh, JKC, Dubé, MP, Bolan, R, Yang, OO, and Kerndt, PR
- Subjects
Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Rare Diseases ,HIV/AIDS ,Clinical Research ,Infectious Diseases ,Tuberculosis ,2.2 Factors relating to the physical environment ,Aetiology ,Infection ,Good Health and Well Being ,Adult ,Ambulatory Care Facilities ,Antitubercular Agents ,Coinfection ,Cross-Sectional Studies ,Female ,Guideline Adherence ,HIV Infections ,HIV-1 ,Humans ,Isoniazid ,Los Angeles ,Male ,Medication Adherence ,Middle Aged ,Practice Guidelines as Topic ,Practice Patterns ,Physicians' ,Public Sector ,Retrospective Studies ,Time Factors ,Treatment Outcome ,HIV-TB co-infection ,isoniazid preventive therapy ,tuberculosis prevention ,latent tuberculous infection ,tuberculosis elimination ,Cardiorespiratory Medicine and Haematology ,Microbiology ,Cardiovascular medicine and haematology ,Clinical sciences ,Epidemiology - Abstract
SettingPublicly funded human immunodeficiency virus (HIV) clinics in Los Angeles County, California, USA.BackgroundHIV-infected persons are a high priority group for targeted testing and treatment for Mycobacterium tuberculosis infection in the United States.ObjectiveTo describe rates of isoniazid (INH) initiation and completion among HIV-1 and M. tuberculosis co-infected persons in Los Angeles County.DesignWe conducted a cross-sectional study using routinely collected surveillance data from publicly funded HIV clinics. We examined differences in INH treatment initiation and completion between four clinic categories: the three largest clinics (Clinics A, B, and C) and 'Other' clinics (pooled data for the remaining 10 clinics).ResultsDuring 2010-2013, 802 (5.3%) of 15 029 HIV-1-infected persons tested positive for M. tuberculosis infection. INH was initiated in 581 (72.4%) persons, of whom 457 (78.7%) completed treatment. We found significant differences between clinics in terms of treatment initiation (range 59.1-93.4%) and completion (range 58.8-82.3%). Overall, 57% (457/802) of HIV and M. tuberculosis co-infected persons completed the recommended treatment (range across clinics 34.8-76.3%).ConclusionWe identified significant gaps in the treatment for M. tuberculosis infection among HIV-infected persons in Los Angeles County. Interventions are needed to improve initiation and completion of treatment for M. tuberculosis infection in this population.
- Published
- 2016