The effect of rifapentine and isonized therapy on IGRA reversion and conversion among HIV positive individuals in Addis Ababa: a retrospective cohort study.
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Date
2020-05
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Addis Abeba University
Abstract
Interferon-γ release assays (IGRAs) such as QFT gold plus is one of the main tools
for the diagnosis of latent TB infection (LTBI). The main objective this study was to
assess the effect of Rifapentin and Isoniazid (3HP) on IGRA reversion and
conversion.
IGRA reversion and conversion rates have generally been reported after preventive
TB therapy, but rates vary widely depending on different settings and there was no
study conducted in Ethiopia on IGRA reversion and conversion in post 3HP.
A retrospective cohort study of 519 human immunodeficiency virus (HIV) positive
individuals who had follow up at Zewditu and Alert Hospitals in Addis Ababa,
Ethiopia underwent testing with QuantiFERON (QFT) gold plus at enrolment and
12-month follow-up after taking Rifapentine and Isoniazid (3HP) prophylaxis
therapy were included in the final analysis in this study to assess the reversion and
conversion of IGRA.
The rate of IGRA reversion among LTBI positives and the rate of conversion among
latent Tuberculosis infection (LTBI) negative at baseline was 67/169 (39.6 %) and
66/350 (18.9 %) respectively. The observed high IGRA conversion rates indicated a
higher rate of Mycobacterium TB infection among LTBI negative patients despite
taking 3HP. The prevalence of LTBI among HIV positive individuals was found to
be 169/519 (32.6 %; 95% CI 28.5% to 36.5%). Having a history of tuberculosis is
substantially associated with LTBI (AOR=1.7 [95% CI 1.15, 2.52]).
IGRA reversion rate after taking Rifapentin – INH prophylaxis therapy was fairly
high and the rate of IGRA conversion was high despite taking the tuberculosis
prophylaxis. Hence targeted screening approach for diagnosing latent tuberculosis
infection in HIV/AIDS patients using appropriate methods before administration of
TB preventive therapy is recommended.
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Keywords
Rifapentine, isonized therapy ,IGRA reversion ,HIV positive