Results from the ACTG 5279 study, examining an ultra-short regimen, have real potential to make an impact on treatment of LTBI and reduction of new cases of TB.

Our standard of care in Canada, for decades, has been 9 months of daily INH; with poor treatment uptake and poor treatment completion rates.

At the 2018 CROI conference, Richard Chaisson presented results of the large ACTG 5279 study.   Between 2012 and 2014, the study enrolled 3,000 people 13 years of age and older living with HIV in Botswana, Brazil, Haiti, Kenya, Malawi, Peru, South Africa, Thailand, the United States and Zimbabwe.

Followed for an average 3 years, the rate of TB incidence was similar in both treatment arms: only 32 participants in the one-month regimen and 33 in the nine-month regimen developed active TB disease.   There were even fewer adverse events in the one-month treatment arm.

Based on this study, and studies of the 12 dose once weekly HP regimen, should there be calls to scale up these regimens in Canada.  What are the barriers to offering these shorter, safer regimens to people in Canada with LTBI?  Post comments below…

And, a great overview of recent developments in TB presented at CROI by Richard Chaisson – available online – click here.