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AutorDowdy, David W.
AutorGolub, Jonathan E.
AutorSaraceni, Valeria
AutorMoulton, Lawrence H.
AutorCavalcante, Solange C.
AutorCohn, Silvia
AutorPacheco, Antonio G.
AutorChaisson, Richard E.
AutorDurovni, Betina
Fecha de acceso2019-09-09T12:53:25Z
Fecha de disponibilización2019-09-09T12:53:25Z
Fecha de publicación2014
ReferenciaDOWDY, David W. et al. Impact of isoniazid preventive therapy for HIV-infected adults in Rio de Janeiro, Brazil: an epidemiological model. Journal of Acquired Immune Deficiency Syndromes, v. 66, n. 5, p. 1-16, 2014.
ISSN1525-4135
URIhttps://www.arca.fiocruz.br/handle/icict/35394
DescripciónSolange C. Cavalcante. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.pt_BR
Idiomaengen_US
EditorLippincott, Williams & Wilkins
Derechos de autoropen access
TítuloImpact of isoniazid preventive therapy for HIV-infected adults in rio de Janeiro, Brazil: an epidemiological modelen_US
Tipo del documentoPreprint
DOI10.1097/QAI.0000000000000219
Resumen en InglésBackground —The potential epidemiological impact of isoniazid preventive therapy (IPT), delivered at levels that could be feasibly scaled up among people living with HIV (PLHIV) in modern, moderate-burden settings, remains uncertain. Methods — We used routine surveillance and implementation data from a cluster-randomized trial of IPT among HIV-infected clinic patients with good access to antiretroviral therapy in Rio de Janeiro, Brazil, to populate a parsimonious transmission model of TB/HIV. We modeled IPT delivery as a constant process capturing a proportion of the eligible population every year. We projected feasible reductions in tuberculosis (TB) incidence and mortality in the general population and among PLHIV specifically at the end of five years after implementing an IPT program. Results — Data on time to IPT fit an exponential curve well, suggesting that IPT was delivered at a rate covering 20% (95% confidence interval: 16%, 24%) of the 2,500 eligible individuals each year. By the end of year 5 after modeled program roll-out, IPT had reduced TB incidence by 3.0% (95% uncertainty range, UR: 1.6%, 7.2%) in the general population and by 15.6% (95%UR: 15.5%, 36.5%) among PLHIV. Corresponding reductions in TB mortality were 4.0% (95%UR: 2.2%, 10.3%) and 14.3% (14.6%, 33.7%). Results were robust to wide variations in parameter values on sensitivity analysis. Conclusions — TB screening and IPT delivery can substantially reduce TB incidence and mortality among PLHIV in urban, moderate-burden settings. In such settings, IPT can be an important component of a multi-faceted strategy to feasibly reduce the burden of TB in PLHIV.en_US
AfiliaciónJohns Hopkins University. School of Medicine. Center for Tuberculosis Research. Baltimore, MA, USA / Johns Hopkins University. Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MA, USA.
AfiliaciónJohns Hopkins University. School of Medicine. Center for Tuberculosis Research. Baltimore, MA, USA / Johns Hopkins University. Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MA, USA.
AfiliaciónMunicipal Health Secretariat. Rio de Janeiro, RJ, Brazil.
AfiliaciónJohns Hopkins University. Johns Hopkins Bloomberg School of Public Health. Department of International Health. Baltimore, MA, USA.
AfiliaciónMunicipal Health Secretariat. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
AfiliaciónJohns Hopkins University. School of Medicine. Center for Tuberculosis Research. Baltimore, MA, USA
AfiliaciónFundação Oswaldo Cruz. Presidência. Programa de Computação Científica. Rio de Janeiro, RJ, Brasil.
AfiliaciónJohns Hopkins University. School of Medicine. Center for Tuberculosis Research. Baltimore, MA, USA / Johns Hopkins University. Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MA, USA / Johns Hopkins University. Johns Hopkins Bloomberg School of Public Health. Department of International Health. Baltimore, MA, USA.
AfiliaciónMunicipal Health Secretariat. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.
Palavras clave en InglêsTuberculosisen_US
Palavras clave en InglêsInfectious disease transmissionen_US
Palavras clave en InglêsHIVen_US
Palavras clave en InglêsTheoretical modelsen_US
Palavras clave en InglêsBrazilen_US
Palavras clave en InglêsIsoniaziden_US
e-ISSN1944-7884
Fecha de embargo2020-09-09


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