ReviewThe Lancet regional health. Southeast Asia2024
The 3 HP regimen for tuberculosis preventive treatment: safety, dosage and related concerns during its large-scale implementation in countries like India.
Review in The Lancet regional health. Southeast Asia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical effectiveness of three months once-weekly Isoniazid and Rifapentine regimen for treatment of Latent TB Infection: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Treatment completion and safety profile of once-weekly 3HP regimen for tuberculosis preventive treatment in children and adolescents: a systematic review.BMC infectious diseases · 2025Pooled it
- A Novel Therapy With a One-Month Ultrashort Regimen to Halt Progression From Latent Infection to Active Tuberculosis Among Close Contacts (The TB‑YOUTH Study): Protocol for a Cluster Randomized Controlled Trial.JMIR research protocols · 2026Article
- Multidrug-resistant tuberculosis: a comprehensive review of pathogenesis, drug resistance, current treatment and future prospects.Archives of microbiology · 2026Review
- Programmatic impact and cost-effectiveness of scaling up the short-course 3HP regimen for tuberculosis preventive treatment in Brazil.BMJ global health · 2026Article
- Reappraising TB preventive treatment in India: programmatic and ethical implications of subclinical tuberculosis in household contacts.The Lancet regional health. Southeast Asia · 2026Review
- Efficacy and safety of a novel short course rifapentine and isoniazid regimen for the preventive treatment of tuberculosis in Chinese silicosis patients: a pilot study (SCRIPT-TB).Emerging microbes & infections · 2025Article
- Advancement in diagnostic approaches for latent tuberculosis: distinguishing recent from remote infections.One health outlook · 2025Review
Corrections and comments
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1 author.
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Abstract
The 3-month once-weekly isoniazid-rifapentine (3 HP) regimen for tuberculosis preventive treatment recommended by WHO is being rolled in countries including India. It has higher completion rates and lower risk of hepatotoxicity than isoniazid preventive treatment, but trials also showed higher frequency of systemic drug reactions (SDRs) including flu-like syndromes and dizziness, and also uncommon Grade 3 or 4 adverse events like hypotension, syncope, bronchospasm. Low BMI is a risk factor for SDRs. Available data on safety of 3 HP in the Asian region is limited, heterogeneous, but points to a higher frequency of SDRs suggesting a need for caution in its large-scale implementation. 19% (118/614) of household contacts initiated on 3 HP in Delhi reported dizziness. Multiple lines of evidence including pharmacokinetic data suggest that the SDRs may be related to isoniazid and its plasma concentration. WHO and national guidelines for the 3 HP regimen currently recommend a fixed dose of once-weekly 900 mg isoniazid in adults regardless of body weight that poses a risk of SDRs for lower weight adults, amplified by the acetylator status and the lack of co-administration of pyridoxine. Weight based dosing, co-administration of pyridoxine and pharmacovigilance studies should accompany the roll out of 3 HP to ensure its safe and successful implementation.
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