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Abstract
Latent Mycobacterium tuberculosis infection (ILTB) treatment is a strategic priority to eliminate tuberculosis in countries with a high incidence, such as Brazil. Shorter-course regimens have been recommended to provide adherence to prophylactic treatment. This review examines the efficacy and safety evidence of 3-month isoniazid-rifapentine (3HP) compared to 9-month isoniazid (9H) in LTBI treatment. We conducted a systematic review with meta-analysis following the PRISMA checklist. Structured searches on Medline (PUBMED), EMBASE, Cochrane Library, LILACS, Scopus and Web of Science platforms were performed in August 2020. 586 publications were found and 7 complete studies were included in the analysis. The results show that 3HP was superior to 9H in the treatment completion outcome, with statistical significance (OR = 2.92; 95%CI = 2.07-4.12). Fewer cases of active tuberculosis occurred in patients treated with 3HP, but the relative risk showed no statistically significant difference (RR = 0.47; 95%CI = 0.2-1.12). Rates of severe hepatotoxicity ranged between 0% and 1.5% for 3HP and between 1.2% and 5.3% for 9H. There were no deaths attributed to treatments. The 3HP regimen is as safe and effective as the 9H and promotes significantly higher treatment completion rates. The adoption of 3HP in the treatment of LTBI can contribute to the country’s efforts to eliminate tuberculosis as a public health problem.
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