scholarly journals Completion and adverse drug events of latent tuberculosis infection treatment in patients receiving dialysis: predictors and impacts of different regimens in a prospective cohort study

2020 ◽  
Author(s):  
Shu-Yung Lin ◽  
Jia-Yih Feng ◽  
Chih-Yuan Lee ◽  
Yi-Chih Lin ◽  
Yu-Hsiang Chou ◽  
...  
Keyword(s):  
Adverse Drug Events ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Completion Rate ◽  
Tuberculosis Infection ◽  
Maintenance Hemodialysis ◽  
Treatment Termination ◽  
And Gender ◽  
Stage Renal Disease ◽  
End Stage

Objectives: Although patients with end-stage renal disease receiving maintenance hemodialysis are at high risk for tuberculosis, the optimal treatment regimen for latent tuberculosis infection (LTBI) in this group has scarcely been studied for predictors of completion rate and adverse drug events (ADE). Methods: We prospectively enrolled dialysis patients for LTBI intervention from three medical centers in Taiwan. LTBI treatments were three-month weekly rifapentine plus isoniazid (3HP) and nine-month daily isoniazid (9H). Completion rate, ADE, and reasons for treatment termination were recorded. Factors associated with treatment termination and ADE were analyzed using multivariate logistic regression. Results: In all, 91 treatment courses (41 9H and 50 3HP) were surveyed. The completion rates were 61% for 9H and 82% for 3HP (p=0.046). Use of 9H and development of ≥grade 2 ADEs were associated with treatment termination. Hypersensitivity occurred in 29.2% of subjects in the 3HP group and 10.8% in the 9H group (p=0.035) and independently correlated with 3HP regimen, diabetes mellitus (DM) and peritoneal dialysis (PD). Similarly, the independent predictors of ≥grade 2 ADEs were use of 3HP regimen, presence of DM, and use of PD, whereas ≥grade 3 ADEs were associated with eosinophil >700/mm3 after 2 weeks of LTBI treatment even after adjustment for age and gender. Conclusions: For patients on dialysis, 3HP showed a higher rate of completion but also a higher rate of ≥grade 2 ADE than 9H. In addition, DM and PD were risk for ≥grade 2 ADE. Eosinophilia after 2-week treatment might be an alert for severe ADE.

scholarly journals Nutritional Adequacy and Latent Tuberculosis Infection in End-Stage Renal Disease Patients

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2299
Author(s):  
Seung Don Baek ◽  
Soomin Jeung ◽  
Jae-Young Kang
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Nutritional Adequacy ◽  
Dialysis Adequacy ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: Latent tuberculosis infection (LTBI) is prevalent in end-stage renal disease (ESRD) patients. The risk of tuberculosis activation is also high. The appropriate LTBI screening and treatment is required in this population. Meanwhile, whether hemodialysis adequacy is associated with LTBI in the ESRD population is unclear. In this study, we aimed to investigate the association between hemodialysis adequacy and LTBI in ESRD patients. Methods: In the present cross-sectional study, we reviewed all outpatient-based ESRD patients in our artificial kidney room. Interferon gamma release assay (IGRA) was used for the diagnosis of LTBI. Clinical variables including nutritional adequacy (i.e., normalized protein catabolic rate, nPCR) and dialysis adequacy (i.e., Kt/V) were compared between IGRA-positive and IGRA-negative patients. Results: A total of 90 patients were enrolled, of which 20 (22.2%) had positive IGRA results using the QuantiFERON-TB method. Old fibrotic changes and nPCR (g/kg/day) were significantly different between IGRA-positive and IGRA-negative patients (both p < 0.005), while serum albumin and Kt/V were comparable (p = 0.429 and p = 0.590, respectively). Normalized PCR remained to be significant in a multivariate logistic regression analysis (adjusted hazard ratio, 0.911 (0.861–0.963); p = 0.001). The cutoff nPCR value less than 0.87 g/kg/day had an adjusted hazard ratio of 7.74 (1.77–33.74) for predicting LTBI. Patients with nPCR value less than 0.87 g/kg/day were older and had lower serum hemoglobin, albumin, calcium concentration, and Kt/V levels than those with nPCR value greater than 0.87 g/kg/day. Conclusions: Nutritional adequacy, especially when assessing nPCR value, was associated with LTBI, while dialysis adequacy was not associated with LTBI.

γδ T-cell function is inhibited in end-stage renal disease and impacted by latent tuberculosis infection

2017 ◽  
Vol 92 (4) ◽  
pp. 1003-1014 ◽  
Author(s):  
Jennifer A. Juno ◽  
Jillian L.M. Waruk ◽  
Angela Harris ◽  
Christine Mesa ◽  
Carmen Lopez ◽  
...  
Keyword(s):  
T Cell ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cell Function ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Γδ T Cell ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Completion rate of latent tuberculosis infection treatment in patients aged 65 years and older

2019 ◽  
Vol 157 ◽  
pp. 52-58 ◽  
Author(s):  
Chang Suk Noh ◽  
Hwan Il Kim ◽  
Hayoung Choi ◽  
Youlim Kim ◽  
Cheol-Hong Kim ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Completion Rate ◽  
Tuberculosis Infection ◽  
Infection Treatment

scholarly journals Safety and Completion Rate of Short‐Course Therapy for Treatment of Latent Tuberculosis Infection

2006 ◽  
Vol 43 (3) ◽  
pp. 271-275 ◽  
Author(s):  
Paul P. Cook ◽  
Ricardo A. Maldonado ◽  
Connie T. Yarnell ◽  
Don Holbert
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Completion Rate ◽  
Tuberculosis Infection ◽  
Short Course

scholarly journals Completion Rates, Adverse Effects, and Costs of a 3-Month and 9-Month Treatment Regimen for Latent Tuberculosis Infection in California Inmates, 2011-2014

2019 ◽  
Vol 134 (1_suppl) ◽  
pp. 71S-79S ◽  
Author(s):  
Charlotte Wheeler ◽  
Janet Mohle-Boetani
Keyword(s):  
Latent Tuberculosis Infection ◽  
Treated Patient ◽  
Prison Population ◽  
Latent Tuberculosis ◽  
Treatment Completion ◽  
Completion Rate ◽  
Tuberculosis Infection ◽  
High Rate ◽  
Initiation Rate ◽  
The Cost

Objectives: In California, about 80% of tuberculosis disease is caused by untreated latent tuberculosis infection (LTBI), and the rate of LTBI is higher among incarcerated persons (16%) than among nonincarcerated persons (6%). We compared 2 regimens to treat LTBI in an adult prison population in California: 9 months of twice-weekly isoniazid (9H; previous standard of care) and 12 once-weekly doses of isoniazid and rifapentine (3HP; introduced in 2011). Methods: We evaluated the rates of completion and discontinuation caused by hepatotoxicity among randomly selected patients with LTBI prescribed the 9H regimen in 2011 and among patients with LTBI prescribed the 3HP regimen who entered California prisons during September 2013–March 2014. We compared the cost per fully treated patient for the 2 regimens. Results: Of 92 patients treated with the 9H regimen, the treatment completion rate was 42% and discontinuation due to hepatotoxicity was 14%. Of 122 patients who accepted the 3HP regimen, the completion rate was 90% and discontinuation due to hepatotoxicity was 2%. The cost per fully treated patient for the 9H regimen was $981 and for 3HP was $652. Conclusions: In an incarcerated population, the 3HP regimen had a higher completion rate, lower hepatotoxicity, and lower cost per fully treated patient than the 9H regimen. If coupled with a high treatment initiation rate, the high rate of LTBI treatment completion with 3HP may contribute to reducing tuberculosis morbidity in California.

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