OBJECTIVE: The TB/HIV in Rio (THRio) study was launched in September 2005 to assess the impact of integrated tuberculosis (TB) and HIV treatment strategies in 29 HIV clinics in Rio de Janeiro, Brazil. DESIGN:THRio is a cluster-randomized trial (CRT) to determine whether routine screening for and treatment of latent TB in HIV clinic patients with access toantiretroviral therapy will reduce TB incidence at the clinic level. THRio is part of the Consortium to Respond Effectively to AIDS/TB Epidemic that is implementing research studies to assess the impact of bold, new public health paradigms for controlling the AIDS/TB epidemic. METHODS:Twenty-nine public primary HIV clinics were randomly assigned a date to begin implementing TB screening procedures and provision of isoniazid preventive therapy (IPT) for TB/HIV coinfected patients. Final analysis of the CRT is expected in 2011. RESULTS: Starting at date of tuberculin skin test (TST)/IPT implementation at each clinic through August 2010, 1670 HIV-infected patients initiated IPT, of which 215 are still receiving treatment. Of the remaining 1455 patients, 1230 (85%) completed therapy and only 20 (1.2%) patients initiating IPT reported adverse reactions leading to discontinuation of therapy. IPT completion was higher among HIV-infected patients receiving HAART (87%) than those not yet receiving HAART (79%, P < 0.01). Times to TST and IPT have markedly decreased postintervention, but remain considerably long. The richness of the THRio database has resulted in several analyses of this expansive cohort of HIV-infected patients that are reviewed here. CONCLUSIONS: The national implementation of TST and IPT for HIV-positive patients in Brazil has been invigorated partly due to THRio's baseline results. Expanded use of IPT in HIV patients in Rio de Janeiro is achievable with high adherence and low adverse events, although this effort requires a package of activities including training, advocacy and reorganization of services.
RCT Entities:
OBJECTIVE: The TB/HIV in Rio (THRio) study was launched in September 2005 to assess the impact of integrated tuberculosis (TB) and HIV treatment strategies in 29 HIV clinics in Rio de Janeiro, Brazil. DESIGN:THRio is a cluster-randomized trial (CRT) to determine whether routine screening for and treatment of latent TB in HIV clinicpatients with access to antiretroviral therapy will reduce TB incidence at the clinic level. THRio is part of the Consortium to Respond Effectively to AIDS/TB Epidemic that is implementing research studies to assess the impact of bold, new public health paradigms for controlling the AIDS/TB epidemic. METHODS: Twenty-nine public primary HIV clinics were randomly assigned a date to begin implementing TB screening procedures and provision of isoniazid preventive therapy (IPT) for TB/HIV coinfectedpatients. Final analysis of the CRT is expected in 2011. RESULTS: Starting at date of tuberculin skin test (TST)/IPT implementation at each clinic through August 2010, 1670 HIV-infectedpatients initiated IPT, of which 215 are still receiving treatment. Of the remaining 1455 patients, 1230 (85%) completed therapy and only 20 (1.2%) patients initiating IPT reported adverse reactions leading to discontinuation of therapy. IPT completion was higher among HIV-infectedpatients receiving HAART (87%) than those not yet receiving HAART (79%, P < 0.01). Times to TST and IPT have markedly decreased postintervention, but remain considerably long. The richness of the THRio database has resulted in several analyses of this expansive cohort of HIV-infectedpatients that are reviewed here. CONCLUSIONS: The national implementation of TST and IPT for HIV-positivepatients in Brazil has been invigorated partly due to THRio's baseline results. Expanded use of IPT in HIV patients in Rio de Janeiro is achievable with high adherence and low adverse events, although this effort requires a package of activities including training, advocacy and reorganization of services.
Authors: C C Whalen; J L Johnson; A Okwera; D L Hom; R Huebner; P Mugyenyi; R D Mugerwa; J J Ellner Journal: N Engl J Med Date: 1997-09-18 Impact factor: 91.245
Authors: Guilherme Santoro-Lopes; Ana Maria Felix de Pinho; Lee H Harrison; Mauro Schechter Journal: Clin Infect Dis Date: 2002-01-07 Impact factor: 9.079
Authors: N A Halsey; J S Coberly; J Desormeaux; P Losikoff; J Atkinson; L H Moulton; M Contave; M Johnson; H Davis; L Geiter; E Johnson; R Huebner; R Boulos; R E Chaisson Journal: Lancet Date: 1998-03-14 Impact factor: 79.321
Authors: Lawrence H Moulton; Jonathan E Golub; Betina Durovni; Solange C Cavalcante; Antonio G Pacheco; Valeria Saraceni; Bonnie King; Richard E Chaisson Journal: Clin Trials Date: 2007 Impact factor: 2.486
Authors: Elizabeth L Corbett; Catherine J Watt; Neff Walker; Dermot Maher; Brian G Williams; Mario C Raviglione; Christopher Dye Journal: Arch Intern Med Date: 2003-05-12
Authors: Jonathan E Golub; Valeria Saraceni; Solange C Cavalcante; Antonio G Pacheco; Lawrence H Moulton; Bonnie S King; Anne Efron; Richard D Moore; Richard E Chaisson; Betina Durovni Journal: AIDS Date: 2007-07-11 Impact factor: 4.177
Authors: Antonio G Pacheco; Betina Durovni; Solange C Cavalcante; L M Lauria; Richard D Moore; Lawrence H Moulton; Richard E Chaisson; Jonathan E Golub Journal: PLoS One Date: 2008-09-10 Impact factor: 3.240
Authors: David W Dowdy; Jonathan E Golub; Valeria Saraceni; Lawrence H Moulton; Solange C Cavalcante; Silvia Cohn; Antonio G Pacheco; Richard E Chaisson; Betina Durovni Journal: J Acquir Immune Defic Syndr Date: 2014-08-15 Impact factor: 3.731
Authors: Betina Durovni; Valeria Saraceni; Lawrence H Moulton; Antonio G Pacheco; Solange C Cavalcante; Bonnie S King; Silvia Cohn; Anne Efron; Richard E Chaisson; Jonathan E Golub Journal: Lancet Infect Dis Date: 2013-08-16 Impact factor: 25.071
Authors: M Azadi; D M Bishai; D W Dowdy; L H Moulton; S Cavalcante; V Saraceni; A G Pacheco; S Cohn; R E Chaisson; B Durovni; J E Golub Journal: Int J Tuberc Lung Dis Date: 2014-12 Impact factor: 2.373
Authors: D W Dowdy; G Israel; V Vellozo; V Saraceni; S Cohn; S Cavalcante; R E Chaisson; J E Golub; B Durovni Journal: Int J Tuberc Lung Dis Date: 2013-01-14 Impact factor: 2.373
Authors: I Pathmanathan; S Ahmedov; E Pevzner; G Anyalechi; S Modi; H Kirking; J S Cavanaugh Journal: Int J Tuberc Lung Dis Date: 2018-06-01 Impact factor: 2.373