Thuy T Trinh1, Dien T Han2, Emily Bloss3, Thai H Le4, Tung T Vu5, Anh H Mai6, Nhung V Nguyen2, Long T Nguyen5, Sy N Dinh2, Sara Whitehead7. 1. U.S. Centers for Disease Control and Prevention, US Embassy, 7 Lang Ha street, Hanoi, Vietnam Trinhttt@state.gov. 2. Vietnam National TB Program, 463 Hoang Hoa Tham, Hanoi, Vietnam. 3. U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd MS E-10 Atlanta, GA 30333, USA. 4. U.S. Centers for Disease Control and Prevention, US Embassy, 7 Lang Ha street, Hanoi, Vietnam. 5. Vietnam Administration of HIV/AIDS Control (VAAC) and Leadership and Investment in Fighting an Epidemic - Global AIDS Program (LIFE-GAP), 7th floor, HEID building, K3b, 6A lane, Thanh Cong Street, Hanoi, Vietnam. 6. An Giang Provincial TB and HIV/AIDS Control Center, 12B Le Loi, Long Xuyen, An Giang, Vietnam. 7. CDC Southeast Asia Regional Office, DDC 7, Thailand Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand.
Abstract
BACKGROUND: WHO recommends screening for TB and evaluation for isoniazid preventive therapy (IPT) based on evidence that they reduce TB-related morbidity and mortality among HIV-infected persons. In Vietnam, an IPT pilot was implemented in two provinces; TB screening, treatment and outcomes were evaluated to inform the adoption and scale-up of IPT. METHODS: During April 2008 to March 2010, eligible HIV-infected persons aged >15 years, with no previous or current TB treatment, alcohol abuse or liver disease were screened for TB. If TB disease was ruled out based on symptoms, chest x-rays and sputum smears, isoniazid was administered for 9 months. RESULTS: Among 1281 HIV-infected persons who received initial eligibility screening, 520 were referred to and evaluated at district TB clinics for TB disease or IPT eligibility. Active TB was diagnosed in 17 patients and all were started on treatment. Of 520 patients evaluated, 416 (80.0%) initiated IPT: 382 (91.8%) completed IPT, 17 (4.1%) stopped treatment, 8 (1.9%) died, 3 (0.7%) developed TB during IPT and 6 (1.4%) had unknown outcomes. No severe adverse events were reported. CONCLUSIONS: IPT treatment completion was high; no serious complications occurred. Improving and expanding intensified case-finding and IPT should be considered in Vietnam. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
BACKGROUND: WHO recommends screening for TB and evaluation for isoniazid preventive therapy (IPT) based on evidence that they reduce TB-related morbidity and mortality among HIV-infectedpersons. In Vietnam, an IPT pilot was implemented in two provinces; TB screening, treatment and outcomes were evaluated to inform the adoption and scale-up of IPT. METHODS: During April 2008 to March 2010, eligible HIV-infectedpersons aged >15 years, with no previous or current TB treatment, alcohol abuse or liver disease were screened for TB. If TB disease was ruled out based on symptoms, chest x-rays and sputum smears, isoniazid was administered for 9 months. RESULTS: Among 1281 HIV-infectedpersons who received initial eligibility screening, 520 were referred to and evaluated at district TB clinics for TB disease or IPT eligibility. Active TB was diagnosed in 17 patients and all were started on treatment. Of 520 patients evaluated, 416 (80.0%) initiated IPT: 382 (91.8%) completed IPT, 17 (4.1%) stopped treatment, 8 (1.9%) died, 3 (0.7%) developed TB during IPT and 6 (1.4%) had unknown outcomes. No severe adverse events were reported. CONCLUSIONS:IPT treatment completion was high; no serious complications occurred. Improving and expanding intensified case-finding and IPT should be considered in Vietnam. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
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