结核病预防疗法的长期保护作用在中/高结核病发病率环境中
Leidy Anne Alves Teixeira1, Braulio Santos1, Marcelo Goulart Correia1
1Instituto Nacional de Cardiologia, Núcleo de Avaliação de Tecnologias em Saúde, Rio de Janeiro, Brazil.
概括
完成结核病预防疗法 (TPT) 提供了对结核病的长期保护,特别是在HIV阴性个体中. 未完成治疗显著增加结核病的风险.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 临床试验 临床试验
背景情况:
- 结核病预防疗法 (TPT) 提供的保护的持续时间受到辩论.
- 之前的研究表明,关于TPT的长期疗效的结果是相互矛盾的,特别是在不同的人群和发病情况中.
研究的目的:
- 评估结核病预防治疗 (TPT) 的长期保护作用.
- 评估TPT完成或未完成后新结核病例的发生率.
主要方法:
- 一项涉及巴西里约热内卢991名参与者的试验,随机分配给4个月的利法或9个月的异化.
- 新结核病的发病率 (IR) 估计在随机化后的12年内.
- 调整的危险比率 (aHRs) 被计算出来,以确定与发生结核病相关的因素.
主要成果:
- 结核病的整体IR为每1000人年1.7人.
- 与完成者 (1.1/1000 PY) 相比,在没有完成TPT (2.9/1000 PY) 的人群中,结核病IR显著更高.
- 在随机化后28个月内观察到更高的IR,治疗未完成是发生结核病的唯一预测因素 (aHR, 3.2).
结论:
- 完整的结核预防疗法 (TPT) 提供了长期的抗结核保护.
- 这种保护在大多数没有感染艾滋病毒的人群中被观察到.
- 未完成治疗是与增加患结核病风险相关的关键因素.
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