IPT in people living with HIV in Myanmar: a five-fold decrease in incidence of TB disease and all-cause mortality.

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Myanmar faces a substantial burden of co-occurring HIV and tuberculosis (TB).
• Diagnostic tools for latent tuberculous infection are not routinely accessible in Myanmar.
• This highlights a critical need for effective TB prevention strategies among people living with HIV (PLHIV).

Purpose of the Study:

• To evaluate the impact of isoniazid preventive therapy (IPT) on TB disease incidence.
• To assess the effect of IPT on mortality rates among PLHIV.
• To provide evidence for TB prevention in a high-burden setting.

Main Methods:

• Retrospective cohort study utilizing routinely collected data.
• Inclusion of PLHIV enrolled in care between 2009 and 2014.
• Analysis of TB incidence and mortality based on IPT receipt and completion.

Main Results:

• Of 7177 PLHIV, 18% received IPT, with 67% completing the course.
• Completing IPT was associated with a significantly lower risk of incident TB (aHR 0.21).
• IPT receipt significantly reduced the risk of death (aHR 0.25 for completion, aHR 0.55 for non-completion).

Conclusions:

• Completing isoniazid preventive therapy substantially reduces TB disease risk in PLHIV in Myanmar.
• IPT is an effective intervention for reducing mortality among PLHIV.
• These findings support the integration of IPT into HIV care programs in high-burden settings.