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Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts

Background: Tuberculosis (TB) is a major cause of morbidity and mortality in people living with HIV (PLWHIV). Isoniazid preventive therapy (IPT) prevents TB in PLWHIV, but estimates of its effects and actual implementation vary across countries. We reviewed studies that examined the impact of IPT on...

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Autores principales: Assefa, Dawit Getachew, Zeleke, Eden Dagnachew, Bekele, Delayehu, Ejigu, Dawit A., Molla, Wondwosen, Woldesenbet, Tigist Tekle, Aynalem, Amdehiwot, Abebe, Mesfin, Mebratu, Andualem, Manyazewal, Tsegahun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9819739/
https://www.ncbi.nlm.nih.gov/pubmed/36612942
http://dx.doi.org/10.3390/ijerph20010621
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author Assefa, Dawit Getachew
Zeleke, Eden Dagnachew
Bekele, Delayehu
Ejigu, Dawit A.
Molla, Wondwosen
Woldesenbet, Tigist Tekle
Aynalem, Amdehiwot
Abebe, Mesfin
Mebratu, Andualem
Manyazewal, Tsegahun
author_facet Assefa, Dawit Getachew
Zeleke, Eden Dagnachew
Bekele, Delayehu
Ejigu, Dawit A.
Molla, Wondwosen
Woldesenbet, Tigist Tekle
Aynalem, Amdehiwot
Abebe, Mesfin
Mebratu, Andualem
Manyazewal, Tsegahun
author_sort Assefa, Dawit Getachew
collection PubMed
description Background: Tuberculosis (TB) is a major cause of morbidity and mortality in people living with HIV (PLWHIV). Isoniazid preventive therapy (IPT) prevents TB in PLWHIV, but estimates of its effects and actual implementation vary across countries. We reviewed studies that examined the impact of IPT on PLHIV and the factors influencing its implementation in Ethiopia. Methods: We searched PubMed/MEDLINE, Embase, and the Cochrane Central Register of Clinical Controlled Trials from their inception to 1 April 2021 for studies of any design that examined the impact of IPT on PLHIV and the factors influencing its implementation. The protocol was registered in PROSPERO, ID: CRD42021256579. Result: Of the initial 546 studies identified, 13 of which enrolled 12,426 participants, 15,640 PLHIV and 62 HIV clinical care providers were included. PLHIV who were on IPT, independently or simultaneously with ART, were less likely to develop TB than those without IPT. IPT interventions had a significant association with improved CD4 count and reduced all-cause mortality. IPT was less effective in people with advanced HIV infection. The major factors influencing IPT implementation and uptake were stock-outs, fear of developing isoniazid-resistant TB, patient’s refusal and non-adherence, and improper counseling and low commitment of HIV clinical care providers. Conclusion: IPT alone or in combination with ART significantly reduces the incidence of TB and mortality in PLHIV in Ethiopia than those without IPT. More research on safety is needed, especially on women with HIV who receive a combination of IPT and ART. Additionally, studies need to be conducted to investigate the efficacy and safety of the new TPT (3 months combination of isoniazid and rifapentine) in children and people living with HIV.
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spelling pubmed-98197392023-01-07 Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts Assefa, Dawit Getachew Zeleke, Eden Dagnachew Bekele, Delayehu Ejigu, Dawit A. Molla, Wondwosen Woldesenbet, Tigist Tekle Aynalem, Amdehiwot Abebe, Mesfin Mebratu, Andualem Manyazewal, Tsegahun Int J Environ Res Public Health Review Background: Tuberculosis (TB) is a major cause of morbidity and mortality in people living with HIV (PLWHIV). Isoniazid preventive therapy (IPT) prevents TB in PLWHIV, but estimates of its effects and actual implementation vary across countries. We reviewed studies that examined the impact of IPT on PLHIV and the factors influencing its implementation in Ethiopia. Methods: We searched PubMed/MEDLINE, Embase, and the Cochrane Central Register of Clinical Controlled Trials from their inception to 1 April 2021 for studies of any design that examined the impact of IPT on PLHIV and the factors influencing its implementation. The protocol was registered in PROSPERO, ID: CRD42021256579. Result: Of the initial 546 studies identified, 13 of which enrolled 12,426 participants, 15,640 PLHIV and 62 HIV clinical care providers were included. PLHIV who were on IPT, independently or simultaneously with ART, were less likely to develop TB than those without IPT. IPT interventions had a significant association with improved CD4 count and reduced all-cause mortality. IPT was less effective in people with advanced HIV infection. The major factors influencing IPT implementation and uptake were stock-outs, fear of developing isoniazid-resistant TB, patient’s refusal and non-adherence, and improper counseling and low commitment of HIV clinical care providers. Conclusion: IPT alone or in combination with ART significantly reduces the incidence of TB and mortality in PLHIV in Ethiopia than those without IPT. More research on safety is needed, especially on women with HIV who receive a combination of IPT and ART. Additionally, studies need to be conducted to investigate the efficacy and safety of the new TPT (3 months combination of isoniazid and rifapentine) in children and people living with HIV. MDPI 2022-12-29 /pmc/articles/PMC9819739/ /pubmed/36612942 http://dx.doi.org/10.3390/ijerph20010621 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Assefa, Dawit Getachew
Zeleke, Eden Dagnachew
Bekele, Delayehu
Ejigu, Dawit A.
Molla, Wondwosen
Woldesenbet, Tigist Tekle
Aynalem, Amdehiwot
Abebe, Mesfin
Mebratu, Andualem
Manyazewal, Tsegahun
Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts
title Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts
title_full Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts
title_fullStr Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts
title_full_unstemmed Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts
title_short Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts
title_sort isoniazid preventive therapy for prevention of tuberculosis among people living with hiv in ethiopia: a systematic review of implementation and impacts
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9819739/
https://www.ncbi.nlm.nih.gov/pubmed/36612942
http://dx.doi.org/10.3390/ijerph20010621
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