16 May Focus paper F Cobelens in Sci Trans Med

Posted at 18:42h in News, Publications by

For Whom the Bell Tolls: Isoniazid Preventive Therapy and Tuberculosis Drug Resistance

In a Focus paper, Frank Cobelens dicusses the outcomes and implications of a mathematical modeling study by Mills at al in the same issue. Mills' study explores the long-term population-level impact of large-scale isoniazid preventive therapy (IPT) in HIV-infected people taking into account within-host competition of drug-susceptible and drug-resistant M. tuberculosis strains. It suggests an expected increase in drug-resistant tuberculosis even in the absence of resistance amplification during IPT. Together with the risk of providing IPT to patients with undiagnosed tuberculosis disease this expected increase in drug-resistant tuberculosis HIV calls for reconsidering the “double use” of isoniazid for prophylaxis and curative treatment, and for close surveillance of isoniazid resistance in popualtions in which IPT is rolled out as a large-scale intervention.

For Whom the Bell Tolls: Isoniazid Preventive Therapy and Tuberculosis Drug Resistance
Author: Frank G J Cobelens
In: Science Translational Medicine, Vol. 5, Issue 180, p. 180fs12
Link to abstract: PubMed