Table 2.
Summary of Latent Tuberculosis Infection Treatment Guidelines for People With HIV
| Guidelines (Publication Date) | 3HP | 1HP | 4Ra | 3HRa | 9H | 6H |
|---|---|---|---|---|---|---|
| NTCA/CDC (February 2020) [19] | Preferred (“as drug interactions allow”) | No specific recommendation made | “No evidence is available” in PWH | Preferred (“as drug interactions allow”) | Alternative | Alternative |
| DHHS HIV Adult ART (December 2019) [20] | Preferred (only for patients on RAL- or EFV-based regimens) | No specific recommendation made | Preferred (“pay careful attention to potential DDIs with specific ARV drugs”) | No specific recommendation made | Preferred | Preferred |
| DHHS OI (September 2019) [14] | Alternative (only for patients on RAL- or EFV-based regimens) | No specific recommendation made | Alternative | No specific recommendation made | Preferred | No specific recommendation made |
| WHO TB Preventative Therapy (2020) [1] | Preferred | Alternative | Alternative | Preferred | Preferred | Preferred |
| EACS (2020) [15] | Listed option, but RPT not yet approved by EMA | Listed option, but RPT not yet approved by EMA | Preferred (“check interactions with ARVs”) | Preferred (“check interactions with ARVs”) | Preferred (“consider in high-prevalent TB countries”) | Preferred |
Abbreviations: ART, antiretroviral therapy; ARV, antiretroviral; CDC, Centers for Disease Control and Prevention; DHHS, US Department of Health and Human Services; EACS, European AIDS Clinical Society; EMA, European Medicines Agency; EFV, efavirenz; HIV, human immunodeficiency virus; NTCA, National Tuberculosis Controller’s Association; OI, opportunist infection; PWH, people with HIV; RAL, raltegravir; TB, tuberculosis; WHO, World Health Organization; 6H, 6 months of daily isoniazid (INH); 9H, 9 months of daily INH; 1HP, 1 month of daily INH + rifapentine (RPT); 3HP, 3 months of weekly INH + RPT; 3HR, 3 months of daily INH + rifampin (RIF); 4R, 4 months of daily RIF.
aThe NTCA/CDC, DHHS HIV Adult ART, and EACS guidelines note that RIF may be replaced by rifabutin to accommodate potential drug-drug interactions, and pharmacokinetic studies suggest that this may be reasonable. However, there are no formal guideline-based recommendations for the 4Rbt or 3HRbt regimens due to a lack of data on clinical efficacy.