Implementing an isoniazid preventive therapy program for people living with HIV in Thailand

<div><p>Treatment of people living with HIV (PLHIV) with latent tuberculosis (TB) infection using isoniazid preventive therapy (IPT) can reduce the risk of TB disease, however, the scale-up of IPT among PLHIV in Thailand and worldwide has been slow. To hasten the implementation of IPT in Thailand, we developed IPT implementation training curricula and tools for health care providers and implemented IPT services in seven large government hospitals. Of the 659 PLHIV enrolled, 272 (41.3%) reported symptoms of TB and 39 (14.3% of those with TB symptoms) were diagnosed with TB. A total of 346 (52.4%) participants were eligible for IPT; 318 (91.9%) of these participants opted to have a tuberculin skin test (TST) and 52 (16.3% of those who had a TST) had a positive TST result. Among the 52 participants with a positive TST, 46 (88.5%) initiated and 39 (75.0%) completed 9 months of IPT: physicians instructed three participants to stop IPT, two participants were lost to follow-up, one chose to stop therapy, and one developed TB. IPT can be implemented among PLHIV in Thailand and could reduce the burden of TB in the country.</p></div

Results of generalized estimating equations logistic regression analysis of characteristics of people living with HIV with tuberculosis symptoms^* to control for site-level clustering and to determine predictors of TB disease diagnosis at seven hospitals in Thailand, 2010–2011.

<p>Results of generalized estimating equations logistic regression analysis of characteristics of people living with HIV with tuberculosis symptoms^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0184986#t002fn002" target="_blank">*</a>} to control for site-level clustering and to determine predictors of TB disease diagnosis at seven hospitals in Thailand, 2010–2011.</p

Assessment of 272 people living with HIV who reported tuberculosis symptoms at baseline.

<p>Assessment of 272 people living with HIV who reported tuberculosis symptoms at baseline.</p

Results of generalized estimating equations logistic regression analysis of baseline characteristics of 316 people living with HIV who had a tuberculin skin test (TST) to determine predictors of a positive TST result (≥5mm of induration).

<p>Results of generalized estimating equations logistic regression analysis of baseline characteristics of 316 people living with HIV who had a tuberculin skin test (TST) to determine predictors of a positive TST result (≥5mm of induration).</p

Participant flow.

<p>Participant flow.</p

Baseline characteristics of people living with HIV assessed for symptoms of tuberculosis^* at seven hospitals in Thailand, 2010–2011.

<p>Baseline characteristics of people living with HIV assessed for symptoms of tuberculosis^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0184986#t001fn002" target="_blank">*</a>} at seven hospitals in Thailand, 2010–2011.</p