Community-wide isoniazid preventive therapy drives drug-resistant tuberculosis: a model-based analysis.

ABSTRACT: Tuberculosis (TB) control is especially difficult in settings of high HIV prevalence; HIV co-infection erodes host immunity and increases risk of progression to active TB. Studies have demonstrated that a 6-month (or longer) course of monotherapy with isoniazid [isoniazid preventive therapy (IPT)] can reduce this risk. The World Health Organization endorses IPT for symptom-free individuals with HIV/TB co-infection and has recommended expanding IPT to entire communities (community-wide IPT). Although previous reviews have not found a statistically significant elevated risk of isoniazid-resistant TB among individuals previously treated with IPT, community-wide IPT programs may nonetheless generate substantial selective pressure and increase the burden of drug-resistant TB (DRTB). We develope

SUBMITTER: Mills HL 

PROVIDER: S-EPMC3714172 | biostudies-literature | 2013 Apr

REPOSITORIES: biostudies-literature