Successful use of rifampicin for Hispanic foreign-born patients with latent tuberculosis infection
Abstract:SETTING: Four months of rifampicin (4R) is recommended for the treatment of latent tuberculosis infection (LTBI), although data regarding its use are limited. The majority of tuberculosis (TB) cases in the USA occur among foreign-born persons.
OBJECTIVE: To determine tolerability, hepatotoxicity and completion rates associated with 4R among foreign-born persons.
DESIGN: We retrospectively evaluated 4R treatment among a cohort of predominantly Hispanic foreign-born LTBI patients in four Middle-Tennessee public health clinics from February 2000 to February 2004. Patients' charts were reviewed to abstract demographic, social and clinical data. 4R completion rates, new symptoms and hepatotoxicity (serum aminoalanine transferase ≥120U/l with gastrointestinal symptoms or ≥200 regardless of symptoms) were evaluated.
RESULTS: Of 749 patients treated, 571 (76%) completed 4R. Among all subjects, Hispanics had a lower risk of non-completion (OR 0.6, 95%CI 0.4–0.7) than non-Hispanics. Among non-Hispanic subjects, the risk of non-completion was higher for Blacks than non-Blacks (adjusted OR 2.6, 95%CI 1.5–4.7), but was lower for foreign-born than non-foreign-born subjects (adjusted OR 0.5, 95%CI 0.2–0.9). During treatment, 85 subjects (11%) developed new symptoms, and hepatotoxicity occurred in three patients.
CONCLUSION: With high completion rates and minimal side effects, 4R is a favorable LTBI treatment regimen for Hispanic and other foreign-born patients.
Document Type: Regular Paper
Affiliations: 1: Tennessee Department of Health, Nashville, Tennessee, USA; and Vanderbilt University Medical Center, Division of Infectious Diseases, Department of Medicine, Nashville, Tennessee, USA 2: Tennessee Department of Health, Nashville, Tennessee, USA 3: Centers for Disease Control and Prevention, Division of Tuberculosis Elimination, Atlanta, Georgia, USA
Publication date: February 1, 2008
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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