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IPT reduces mortality in patients with HIV independent of ART

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SEATTLE — Six months of a tuberculosis prevention regimen significantly reduced mortality in African patients with HIV in a recent follow-up study.

The results were presented at the annual Conference on Retroviruses and Opportunistic Infections (CROI). They measured the effects of isoniazid prophylaxis (IPT) on patients with HIV involved in a previous study performed in Cote d’Ivoire.

“Most randomized, controlled trials of IPT have been performed in the pre-ART era and in patients with a low CD4 (T lymphocyte) count,” the follow-up study’s lead author, Anani D. Badje, MD, said during a press conference.

“Today we presented, for the first time, randomized evidence that IPT decreases mortality in HIV–infected adults with high CD4 counts and in the ART era.”

Badje and colleagues followed up on the Temprano ANRS study of 2,056 patients, published in the New England Journal of Medicine in August 2015. Subjects were assigned to one of four groups, and half received 6 months of IPT.  Researchers concluded then that immediate commencement of ART and 6 months of IPT reduced the rate of severe illness.

Follow-up revealed that, of those patients who received IPT, 34 died, whereas among those who did not received IPT, 52 died. The mean baseline CD4 count was 477/mm³.

Researchers concluded that the 6-month IPT regimen yielded a 39% decrease in mortality among the patients, independent of ART and baseline CD4 count.

Badje said the studies have shown IPT and ART complement each other, “with the maximal benefits being reached in the patients who receive both, suggesting that receiving both treatments was the better option.”

“The benefits of 6 months of IPT appeared sustainable up to 6 years after the intervention,” he added. – by Joe Green

Reference:

Badje AD, et al. Six-Month IPT Reduces Mortality Independent of ART in African Adults with High CD4. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 13-16, 2017; Seattle.

Danel C et al, N Eng J Med. 2015; doi: 10.1056/NEJMoa1507198.

Disclosure: The authors reported no relevant financial disclosures.