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Single-Dose Rifapentine in Household Contacts of Patients with Leprosy
Le Wang1, Hongsheng Wang1, Liangbin Yan1
1From the Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, and the National Center for Leprosy Control, Chinese Center for Disease Control and Prevention (CDC) (L.W., Hongsheng Wang, L.Y., M.Y., H.J., Y.S., W.Z., J.S., X. Yang, H.G., G.Z., B.W.), Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, and Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and Sexually Transmitted Infections (Hongsheng Wang), the Department of Epidemiology and Health Statistics, School of Public Health, Southeast University (X. Yu), and the Department of Epidemiology, School of Public Health, Nanjing Medical University (C.S.), Nanjing, Yunnan Provincial CDC, Kunming (J.Y., L.X., J.H., T.S.), Guizhou Provincial CDC, Guiyang (Jinlan Li, J. Liu, D.W., Y.W.), Hunan Provincial CDC, Changsha (Junhua Li, Y.K., B.L., H.C.), Sichuan Provincial People's Hospital, Chengdu (Y.N., Hao Wang, Y. Liu, X.S.), WenShan Prefecture Institute of Dermatology, Wenshan (H.L.), and Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (B.W.) - all in China.
Single-dose rifapentine significantly reduced leprosy incidence in household contacts compared to no intervention. Rifampin showed no significant protective effect, highlighting rifapentine as a promising leprosy prevention strategy.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Previous studies indicated rifampin's protective effect against leprosy in close contacts.
- Rifapentine demonstrated superior in vitro bactericidal activity against Mycobacterium leprae compared to rifampin.
- Limited data existed on rifapentine's efficacy in leprosy prevention.
Purpose of the Study:
- To evaluate the effectiveness of single-dose rifapentine in preventing leprosy among household contacts.
- To compare rifapentine's efficacy against single-dose rifampin and a no-intervention control group.
Main Methods:
- A cluster-randomized, controlled trial was conducted in Southwest China.
- Household contacts were assigned to single-dose rifapentine, rifampin, or control groups.
- The primary outcome measured was the 4-year cumulative incidence of leprosy.
Main Results:
- Leprosy incidence was 0.09% with rifapentine, 0.33% with rifampin, and 0.55% with no intervention over 4 years.
- Rifapentine use resulted in an 84% lower incidence compared to the control group (P=0.02).
- No significant difference in leprosy incidence was observed between the rifampin and control groups.
Conclusions:
- Single-dose rifapentine effectively reduced leprosy incidence in household contacts over a 4-year period.
- Rifapentine represents a potential new strategy for leprosy prevention.
- No severe adverse events were reported during the trial.
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