T. KhawcharoenpornAnucha ApisarnthanarakW. ManosuthiS. SungkanuparphL. M. MundyThammasat University HospitalThailand Ministry of Public HealthMahidol UniversityLM Mundy, LLC2018-06-112018-06-112012-03-01International Journal of Tuberculosis and Lung Disease. Vol.16, No.3 (2012), 336-341102737192-s2.0-84857260766https://repository.li.mahidol.ac.th/handle/20.500.14594/14934SETTING: Human immunodeficiency virus (HIV) clinics at two Thai tertiary care medical centres. OBJECTIVES: To evaluate the efficacy of tuberculin skin test (TST) guided isoniazid preventive therapy (IPT) in combination with antiretroviral therapy (ART) in the prevention of tuberculosis (TB). DESIGN: A 4-year prospective comparative study of patients at two HIV clinics: one performed TST at enrolment and, if positive, prescribed IPT (IPT group), while the other did not perform TST (non-IPT group). RESULTS: There were 200 patients included in each group. Baseline characteristics and drop-out rates were similar in both groups. The incidence of pulmonary TB over 4 years was not significantly different between the IPT and non-IPT groups (0.80 cases vs. 1.76 per 100 person-years [py], P = 0.13). However, the incidence of pulmonary TB in the non-IPT group was significantly higher during the first 6 months (8.60 vs. 0 cases/100 py, P = 0.01) and among patients with initial CD4 < 200 cells/μl (9.41 vs. 0 cases/100 py, P = 0.02). The survival analyses demonstrated a protective effect of IPT (χ 2 = 3.66, P = 0.04) for early TB. CONCLUSIONS: Benefit of IPT plus ART was evident only in the first 6 months of care. These findings suggest that TST-guided IPT should be routinely provided for HIV-infected patients after initial entry into medical care. © 2012 The Union.Mahidol UniversityMedicineArticleSCOPUS10.5588/ijtld.11.0402