Isoniazid therapy for Mycobacterium tuberculosis infection in HIV clinics, Los Angeles, California

Int J Tuberc Lung Dis. 2016 Jul;20(7):961-6. doi: 10.5588/ijtld.15.0988.

Abstract

Setting: Publicly funded human immunodeficiency virus (HIV) clinics in Los Angeles County, California, USA.

Background: HIV-infected persons are a high priority group for targeted testing and treatment for Mycobacterium tuberculosis infection in the United States.

Objective: To describe rates of isoniazid (INH) initiation and completion among HIV-1 and M. tuberculosis co-infected persons in Los Angeles County.

Design: We 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).

Results: During 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%).

Conclusion: We 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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Ambulatory Care Facilities*
  • Antitubercular Agents / therapeutic use*
  • Coinfection*
  • Cross-Sectional Studies
  • Female
  • Guideline Adherence
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology*
  • HIV Infections / virology
  • HIV-1 / isolation & purification
  • Humans
  • Isoniazid / therapeutic use*
  • Los Angeles / epidemiology
  • Male
  • Medication Adherence
  • Middle Aged
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Public Sector
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology

Substances

  • Antitubercular Agents
  • Isoniazid