Treatment responses to integrase strand-transfer inhibitor-containing antiretroviral regimens in combination with short-course rifapentine-based regimens for latent tuberculosis infection among people with HIV.

Integrase Strand-Transfer Inhibitor (INSTI)-Containing Antiretroviral Regimens and Short-Course Rifapentine-Based Regimens for Latent Tuberculosis Infection (LTBI)

This study focuses on the management of latent tuberculosis infection (LTBI) in individuals living with HIV (PWH) by exploring the efficacy and safety of combining short-course rifapentine-based regimens with integrase strand-transfer inhibitor (INSTI)-containing antiretroviral therapy (ART). The researchers conducted a real-world study, enrolling 479 PWH who received either 3 months of weekly rifapentine plus isoniazid (3HP) or 1 month of daily rifapentine plus isoniazid (1HP) in combination with ART. The primary outcome was virologic response within 12 months after LTBI treatment, with secondary outcomes including treatment completion rates and safety of the LTBI regimens. The results indicate that these combinations effectively maintained viral suppression in the majority of PWH within 12 months of LTBI treatment completion, with low rates of grade 3 or higher adverse events. The researchers found no association between the specific LTBI regimen or ART combination and either virologic response or completion rate.

Effective Management of LTBI in People With HIV

The study's findings provide valuable insights into the safe and effective management of LTBI in PWH. The results demonstrate that combining short-course rifapentine-based regimens with INSTI-containing ART can effectively maintain viral suppression, while minimizing the risk of serious adverse events. This research has implications for the development of comprehensive treatment strategies for LTBI in PWH, ensuring optimal outcomes and improving the overall health and well-being of this patient population.

Impact on HIV Treatment and Public Health

This study has far-reaching implications for both HIV treatment and public health. The findings suggest that these combined regimens can contribute to improved HIV management by effectively controlling LTBI, reducing the risk of active tuberculosis, and minimizing the need for lengthy treatment courses. Furthermore, the study's results highlight the potential to enhance public health strategies by ensuring access to safe and effective treatment options for LTBI in PWH.

Dr. Camel's Conclusion

Like a desert oasis, these combined regimens provide much-needed relief for individuals living with HIV and LTBI. The research offers a beacon of hope, showcasing a safe and effective approach to managing LTBI while maintaining viral suppression. As we continue to strive for a world free from HIV and TB, this study serves as a crucial step towards achieving that goal.