Effect of isoniazid preventive therapy on pulmonary tuberculosis activity in people living with hiv/aids at wangaya hospital in Denpasar, Bali, Indonesia: A prospective cohort study

Abstract

Background: Isoniazid Preventive Therapy (IPT) can reduce the Active Pulmonary Tuberculosis (APT) in People living with HIV/AIDS (PLWHA). IPT is recommended by the World Health Organization (WHO). It has not been implemented routinely in all countries. Aim: To evaluate whether IPT in PLWHA reduces the APT at Wangaya Hospital, in Denpasar, Bali, Indonesia. Methods: A prospective cohort study was conducted during October 2014 until November 2016. A total of 244 PLWHA were included in this study. The first group were 122 participants received antiretroviral therapy (ART) and IPT and 122 participants received only ART (second group). Cox regression analysis was employed to calculate effects in both groups and to identify predictor factors for active tuberculosis. The statistical analysis performed with cox proportional hazard model. Results: There were 137 (56.1%) males and 107 (43.9%) females. Incidence of APT in the IPT group was 1.09 per 100 person years and non IPT groups was 12.57 per 100 person years. Incidence of APT in the non IPT groups was significantly higher than in the IPT groups with crude hazard ratio (cHR) of 12.59 (95% CI: 2.70-53.43). After variables adjustment for age, sex and CD4 count, the incidence of APT in the non IPT group were found with adjustment hazard ratio (aHR) of 10.26 (95% CI: 2.15-48.99). Conclusion: The incidence of APT was significantly higher in the non IPT group than in the IPT group.