ArticleAIDS (London, England)2020
Adherence to tuberculosis preventive therapy measured by urine metabolite testing among people with HIV.
Article in AIDS (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Alternative Methods for Therapeutic Drug Monitoring and Dose Adjustment of Tuberculosis Treatment in Clinical Settings: A Systematic Review.Clinical pharmacokinetics · 2023Pooled it
- Trial
- TB will never end because of us: Experiences of TB preventive treatment among people living with HIV/AIDS in South Africa.PloS one · 2025Trial
- Financial incentives for reduced alcohol use and increased isoniazid adherence during tuberculosis preventive therapy among people with HIV in Uganda: an open-label, factorial randomised controlled trial.The Lancet. Global health · 2023Trial
- Mental Health, Substance Use, and Tuberculosis Preventive Therapy in People With HIV: A Prospective Cohort Study.Open forum infectious diseases · 2025Article
- Alcohol use and HIV suppression after completion of financial incentives for alcohol abstinence and isoniazid adherence: a randomized controlled trial.EClinicalMedicine · 2025Article
- Treatment completion and challenges in rolling out 12-dose weekly rifapentine plus isoniazid to prevent tuberculosis among people living with HIV and pediatric household contacts in Brazil.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2025Article
- Association of Toll-Like Receptor Gene Polymorphisms with Tuberculosis in HIV-Positive Participants.Epigenomes · 2023Article
- Patient-centered mobile tuberculosis treatment support tools (TB-TSTs) to improve treatment adherence: A pilot randomized controlled trial exploring feasibility, acceptability and refinement needs.Lancet regional health. Americas · 2022Article
- Understanding Nonadherence to Tuberculosis Medications in India Using Urine Drug Metabolite Testing: A Cohort Study.Open forum infectious diseases · 2021Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
objectivesTuberculosis preventive therapy for people living with HIV is effective, widely recommended, and increasingly prescribed, but completion rates are less than ideal, and adherence is not typically monitored. We sought to quantify adherence to isoniazid preventive therapy using a urine metabolite assay.
designTwo cross-sectional surveys.
settingRio de Janeiro, Brazil, 2008-2009; and Northwest Province, South Africa, 2018-2019.
participantsTwo hundred and three Brazilian and 93 South African patients attending HIV clinics with active prescriptions for isoniazid preventive therapy
main outcome measures: Self-reported isoniazid adherence, paired with semiquantitative measurement of urine isoniazid metabolites.
resultsBy self-report, 90% of patients [95% confidence interval (CI) 86-93%] reported having taken a dose of isoniazid on the day of enrollment or the preceding day, and 91% (95% CI 87-94%) reported missing an average of one dose or fewer per week. By urine testing, only 65% (95% CI 59-70%) of all patients, and 69% (95% CI 63-74%) of those who reported having taken isoniazid on the current or preceding day, had detectable urine metabolites (expected in 95% of patients at 24 h). Longer time since starting preventive therapy was independently associated with a negative urine test for isoniazid metabolites (adjusted prevalence ratio 1.11 per month of isoniazid, 95% CI 1.05-1.18).
conclusionAdherence to isoniazid preventive therapy among patients with HIV in Brazil and South Africa is inadequate, is overestimated by self-report, and declines with time on treatment. Shorter regimens for TB preventive therapy may improve adherence and completion, but adherence support for all patients may be necessary.
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