Checkpoint
Pmc
Racine
Checkpoint
Pmc
Exploration
Accueil
Racine
Racine

Le SIDA en Afrique subsaharienne (serveur d'exploration)

Attention, ce site est en cours de développement !
Attention, site généré par des moyens informatiques à partir de corpus bruts.
Les informations ne sont donc pas validées.

Effect of preventive treatment for tuberculosis in adults infected with HIV: systematic review of randomised placebo controlled trials

Identifieur interne : 002E68 ( Pmc/Checkpoint ); précédent : 002E67; suivant : 002E69

Effect of preventive treatment for tuberculosis in adults infected with HIV: systematic review of randomised placebo controlled trials

Auteurs : David Wilkinson ; S B Squire ; Paul Garner

Source :

RBID : PMC:28654

Abstract

Objective: To determine whether preventive treatment for tuberculosis in adults infected with HIV reduces the frequency of tuberculosis and overall mortality.

Design: Systematic review and data synthesis of randomised placebo controlled trials.

Main outcome measures: Active tuberculosis, mortality, and adverse drug reaction requiring cessation of the study regimen. Outcomes stratified by status of purified protein derivative skin test.

Results: Four trials comprising 4055 adults from Haiti, Kenya, the United States, and Uganda were included. All compared isoniazid (6-12 months) with placebo, and one trial also compared multidrug treatment for 3 months with placebo. Mean follow up was 15-33 months. Overall, frequency of tuberculosis (relative risk 0.57, 95% confidence interval 0.41 to 0.79) was reduced in those receiving preventive treatment compared with placebo: mortality was not significantly reduced (0.93, 0.83 to 1.05). In subjects positive for purified protein derivative receiving preventive treatment, the risk of tuberculosis was reduced substantially (0.32, 0.19 to 0.51) and the risk of death was reduced moderately (0.73, 0.57 to 0.95) compared with those taking placebo. In adults negative for purified protein derivative receiving preventive treatment, the risk of tuberculosis (0.82, 0.50 to 1.36) and the risk of death (1.02, 0.89 to 1.17) were not reduced significantly. Adverse drug reactions were more frequent, but not significantly so, in patients receiving drug compared with placebo (1.45, 0.98 to 2.14).

Conclusions: Preventive treatment given for 3-12 months protects against tuberculosis in adults infected with HIV, at least in the short to medium term. Protection is greatest in subjects positive for purified protein derivative, in whom death is also less frequent. Long term benefits remain to be shown.

Key messages

One third of the world’s population is infected with Mycobacterium tuberculosis

People infected with HIV are at much increased risk of developing active tuberculosis

Short term preventive drug treatment given to people infected with HIV reduces the occurrence of active tuberculosis

The benefit is greatest in people with latent infection, as shown by a positive skin test for tuberculosis, and this group also exhibits a survival benefit


Url:
PubMed: 9727988
PubMed Central: 28654


Affiliations:

Links toward previous steps (curation, corpus...)

Links to Exploration step

PMC:28654

Le document en format XML

<record>
<TEI>
<teiHeader>
<fileDesc>
<titleStmt>
<title xml:lang="en">Effect of preventive treatment for tuberculosis in adults infected with HIV: systematic review of randomised placebo controlled trials</title>
<author>
<name sortKey="Wilkinson, David" sort="Wilkinson, David" uniqKey="Wilkinson D" first="David" last="Wilkinson">David Wilkinson</name>
<affiliation>
<nlm:aff id="N0x9aaa650.0x99876a0"></nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Squire, S B" sort="Squire, S B" uniqKey="Squire S" first="S B" last="Squire">S B Squire</name>
<affiliation>
<nlm:aff id="N0x9aaa650.0x99876a0"></nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Garner, Paul" sort="Garner, Paul" uniqKey="Garner P" first="Paul" last="Garner">Paul Garner</name>
<affiliation>
<nlm:aff id="N0x9aaa650.0x99876a0"></nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt>
<idno type="wicri:source">PMC</idno>
<idno type="pmid">9727988</idno>
<idno type="pmc">28654</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC28654</idno>
<idno type="RBID">PMC:28654</idno>
<date when="1998">1998</date>
<idno type="wicri:Area/Pmc/Corpus">000491</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000491</idno>
<idno type="wicri:Area/Pmc/Curation">000490</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000490</idno>
<idno type="wicri:Area/Pmc/Checkpoint">002E68</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002E68</idno>
</publicationStmt>
<sourceDesc>
<biblStruct>
<analytic>
<title xml:lang="en" level="a" type="main">Effect of preventive treatment for tuberculosis in adults infected with HIV: systematic review of randomised placebo controlled trials</title>
<author>
<name sortKey="Wilkinson, David" sort="Wilkinson, David" uniqKey="Wilkinson D" first="David" last="Wilkinson">David Wilkinson</name>
<affiliation>
<nlm:aff id="N0x9aaa650.0x99876a0"></nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Squire, S B" sort="Squire, S B" uniqKey="Squire S" first="S B" last="Squire">S B Squire</name>
<affiliation>
<nlm:aff id="N0x9aaa650.0x99876a0"></nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Garner, Paul" sort="Garner, Paul" uniqKey="Garner P" first="Paul" last="Garner">Paul Garner</name>
<affiliation>
<nlm:aff id="N0x9aaa650.0x99876a0"></nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">BMJ : British Medical Journal</title>
<idno type="ISSN">0959-8138</idno>
<idno type="eISSN">1468-5833</idno>
<imprint>
<date when="1998">1998</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>
<bold>Objective:</bold>
To determine whether preventive treatment for tuberculosis in adults infected with HIV reduces the frequency of tuberculosis and overall mortality. </p>
<p>
<bold>Design:</bold>
Systematic review and data synthesis of randomised placebo controlled trials. </p>
<p>
<bold>Main outcome measures:</bold>
Active tuberculosis, mortality, and adverse drug reaction requiring cessation of the study regimen. Outcomes stratified by status of purified protein derivative skin test. </p>
<p>
<bold>Results:</bold>
Four trials comprising 4055 adults from Haiti, Kenya, the United States, and Uganda were included. All compared isoniazid (6-12 months) with placebo, and one trial also compared multidrug treatment for 3 months with placebo. Mean follow up was 15-33 months. Overall, frequency of tuberculosis (relative risk 0.57, 95% confidence interval 0.41 to 0.79) was reduced in those receiving preventive treatment compared with placebo: mortality was not significantly reduced (0.93, 0.83 to 1.05). In subjects positive for purified protein derivative receiving preventive treatment, the risk of tuberculosis was reduced substantially (0.32, 0.19 to 0.51) and the risk of death was reduced moderately (0.73, 0.57 to 0.95) compared with those taking placebo. In adults negative for purified protein derivative receiving preventive treatment, the risk of tuberculosis (0.82, 0.50 to 1.36) and the risk of death (1.02, 0.89 to 1.17) were not reduced significantly. Adverse drug reactions were more frequent, but not significantly so, in patients receiving drug compared with placebo (1.45, 0.98 to 2.14). </p>
<p>
<bold>Conclusions:</bold>
Preventive treatment given for 3-12 months protects against tuberculosis in adults infected with HIV, at least in the short to medium term. Protection is greatest in subjects positive for purified protein derivative, in whom death is also less frequent. Long term benefits remain to be shown. </p>
<p>
<boxed-text>
<sec id="KEY.MESSAGES">
<title>Key messages </title>
<p>
<list list-type="bullet">
<list-item>
<p>One third of the world’s population is infected with
<italic>Mycobacterium tuberculosis</italic>
</p>
</list-item>
<list-item>
<p>People infected with HIV are at much increased risk of developing active tuberculosis </p>
</list-item>
<list-item>
<p>Short term preventive drug treatment given to people infected with HIV reduces the occurrence of active tuberculosis </p>
</list-item>
<list-item>
<p>The benefit is greatest in people with latent infection, as shown by a positive skin test for tuberculosis, and this group also exhibits a survival benefit </p>
</list-item>
</list>
</p>
</sec>
</boxed-text>
</p>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">BMJ</journal-id>
<journal-id journal-id-type="publisher-id">BR MED J</journal-id>
<journal-title>BMJ : British Medical Journal</journal-title>
<issn pub-type="ppub">0959-8138</issn>
<issn pub-type="epub">1468-5833</issn>
<publisher>
<publisher-name>British Medical Journal</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">9727988</article-id>
<article-id pub-id-type="pmc">28654</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Papers</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Effect of preventive treatment for tuberculosis in adults infected with HIV: systematic review of randomised placebo controlled trials</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Wilkinson</surname>
<given-names>David</given-names>
</name>
<role>specialist scientist</role>
<xref ref-type="aff" rid="N0x9aaa650.0x99876a0">
<italic>a</italic>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Squire</surname>
<given-names>S B</given-names>
</name>
<role>senior lecturer</role>
<xref ref-type="aff" rid="N0x9aaa650.0x99876a0">
<italic>b</italic>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Garner</surname>
<given-names>Paul</given-names>
</name>
<role>senior lecturer</role>
<xref ref-type="aff" rid="N0x9aaa650.0x99876a0">
<italic>c</italic>
</xref>
</contrib>
</contrib-group>
<aff id="N0x9aaa650.0x99876a0">
<label>
<italic>a</italic>
</label>
Centre for Epidemiological Research in Southern Africa, Medical Research Council, PO Box 187, Mtubatuba 3935, South Africa,
<label>
<italic>b</italic>
</label>
Tropical Medicine Division, Liverpool School of Tropical Medicine, Liverpool L3 5QA,
<label>
<italic>c</italic>
</label>
International Health Division, Liverpool School of Tropical Medicine</aff>
<author-notes>
<fn fn-type="con">
<p>Contributors: DW generated the idea for this review, developed the protocol, conducted the review, and wrote the paper; he will act as guarantor for the paper. SBS provided input on the protocol development and interpretation of the review and commented on the manuscript. PG was coordinating editor for the review and oversaw its quality throughout, provided methodological support, and commented on the manuscript. </p>
</fn>
<fn>
<p>Correspondence to: Dr Wilkinson
<email>wilkinsd@mrc.ac.za</email>
</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<day>5</day>
<month>9</month>
<year>1998</year>
</pub-date>
<volume>317</volume>
<issue>7159</issue>
<fpage>625</fpage>
<lpage>629</lpage>
<history>
<date date-type="accepted">
<day>16</day>
<month>7</month>
<year>1998</year>
</date>
</history>
<copyright-statement>Copyright © 1998, British Medical Journal</copyright-statement>
<copyright-year>1998</copyright-year>
<abstract>
<p>
<bold>Objective:</bold>
To determine whether preventive treatment for tuberculosis in adults infected with HIV reduces the frequency of tuberculosis and overall mortality. </p>
<p>
<bold>Design:</bold>
Systematic review and data synthesis of randomised placebo controlled trials. </p>
<p>
<bold>Main outcome measures:</bold>
Active tuberculosis, mortality, and adverse drug reaction requiring cessation of the study regimen. Outcomes stratified by status of purified protein derivative skin test. </p>
<p>
<bold>Results:</bold>
Four trials comprising 4055 adults from Haiti, Kenya, the United States, and Uganda were included. All compared isoniazid (6-12 months) with placebo, and one trial also compared multidrug treatment for 3 months with placebo. Mean follow up was 15-33 months. Overall, frequency of tuberculosis (relative risk 0.57, 95% confidence interval 0.41 to 0.79) was reduced in those receiving preventive treatment compared with placebo: mortality was not significantly reduced (0.93, 0.83 to 1.05). In subjects positive for purified protein derivative receiving preventive treatment, the risk of tuberculosis was reduced substantially (0.32, 0.19 to 0.51) and the risk of death was reduced moderately (0.73, 0.57 to 0.95) compared with those taking placebo. In adults negative for purified protein derivative receiving preventive treatment, the risk of tuberculosis (0.82, 0.50 to 1.36) and the risk of death (1.02, 0.89 to 1.17) were not reduced significantly. Adverse drug reactions were more frequent, but not significantly so, in patients receiving drug compared with placebo (1.45, 0.98 to 2.14). </p>
<p>
<bold>Conclusions:</bold>
Preventive treatment given for 3-12 months protects against tuberculosis in adults infected with HIV, at least in the short to medium term. Protection is greatest in subjects positive for purified protein derivative, in whom death is also less frequent. Long term benefits remain to be shown. </p>
<p>
<boxed-text>
<sec id="KEY.MESSAGES">
<title>Key messages </title>
<p>
<list list-type="bullet">
<list-item>
<p>One third of the world’s population is infected with
<italic>Mycobacterium tuberculosis</italic>
</p>
</list-item>
<list-item>
<p>People infected with HIV are at much increased risk of developing active tuberculosis </p>
</list-item>
<list-item>
<p>Short term preventive drug treatment given to people infected with HIV reduces the occurrence of active tuberculosis </p>
</list-item>
<list-item>
<p>The benefit is greatest in people with latent infection, as shown by a positive skin test for tuberculosis, and this group also exhibits a survival benefit </p>
</list-item>
</list>
</p>
</sec>
</boxed-text>
</p>
</abstract>
</article-meta>
</front>
</pmc>
<affiliations>
<list></list>
<tree>
<noCountry>
<name sortKey="Garner, Paul" sort="Garner, Paul" uniqKey="Garner P" first="Paul" last="Garner">Paul Garner</name>
<name sortKey="Squire, S B" sort="Squire, S B" uniqKey="Squire S" first="S B" last="Squire">S B Squire</name>
<name sortKey="Wilkinson, David" sort="Wilkinson, David" uniqKey="Wilkinson D" first="David" last="Wilkinson">David Wilkinson</name>
</noCountry>
</tree>
</affiliations>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaSubSaharaV1/Data/Pmc/Checkpoint

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002E68 | SxmlIndent | more

Ou

HfdSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd -nk 002E68 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    SidaSubSaharaV1
   |flux=    Pmc
   |étape=   Checkpoint
   |type=    RBID
   |clé=     PMC:28654
   |texte=   Effect of preventive treatment for tuberculosis in adults infected with HIV: systematic review of randomised placebo controlled trials
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/RBID.i   -Sk "pubmed:9727988" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd   \
       | NlmPubMed2Wicri -a SidaSubSaharaV1
Wicri

This area was generated with Dilib version V0.6.32.
Data generation: Mon Nov 13 19:31:10 2017. Site generation: Wed Mar 6 19:14:32 2024