Zeitschrift für Infektionskrankheiten und Präventivmedizin
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Outcome of Isoniazid Preventive Therapy in Adults Living with HIV in Penang, Malaysia

Lim CL, Wong PS, Pereirasamy L, Ang PP, Leong KN and Chow TS

Isoniazid preventive therapy (IPT) is a recommended strategy by World Health Organization (WHO) for prevention of active TB infection in people living with HIV. However, data on feasibility and outcome of IPT in Asia are limited. We conducted a retrospective study of 242 HIV patients in Penang who were commenced on IPT between 2011 and 2014, at two HIV specialist clinics in Penang General Hospital and Seberang Jaya Hospital. We evaluated the outcome of IPT in terms of completion rate, adverse events and incidence of active TB. A total of 193 (81.1%) patients completed 6 months of IPT. Patients receiving concurrent highly active antiretroviral therapy (HAART) had significantly higher IPT completion rate (86.1%) compared to those who were not on HAART (67.7%). Major reasons for non-completion were adverse events (21/45) and defaulting from follow-up (17/45). Forty patients (18%) developed adverse events, including hepatotoxicity (8.56%) and rash (5.41%). The risk factors for hepatotoxicity were Hepatitis B/C co-infection and alanine transaminase above the upper limit of normal at baseline. None of our patients who received IPT developed active TB up to 1 year of follow-up. IPT is feasible and relatively safe. Coadministration of IPT with HAART does not compromise safety or compliance.