Safety and treatment completion of latent tuberculosis infection treatment in the elderly population-A prospective observational study in Taiwan

Int J Infect Dis. 2020 Jul:96:550-557. doi: 10.1016/j.ijid.2020.05.009. Epub 2020 May 17.

Abstract

Background: The detection and treatment of latent tuberculosis infection (LTBI) is a key step in eliminating tuberculosis (TB), but information on safety and on treatment interruption in elderly LTBI patients remains limited.

Methods: This multicenter prospective observational study included individuals with LTBI who underwent preventive therapy. Incidents of systemic adverse reactions (SARs) and treatment interruption rates in an elderly group (≥60 years old) and a young group (<60 years old) were analyzed.

Results: A total of 406 LTBI patients, comprising 167 elderly and 239 young patients, were included in the analyses. The incidence of SARs was similar in the elderly group (18%) and the young group (15.1%). Being middle-aged (35-59 years), body mass index <23 kg/m2, a regimen of 3 months of once-weekly rifapentine plus isoniazid, and end-stage renal disease were independent factors associated with SARs. The treatment interruption rate was similar between the elderly group (21.6%) and the young group (15.9%). LTBI patients aged ≥80 years with SARs had the highest risk of treatment interruption.

Conclusions: The occurrence of SARs was similar in the elderly (≥60 years old) and young (<60 years old) LTBI patients receiving preventive therapy. Extremely old (≥80 years old) LTBI patients had a higher treatment interruption rate, especially when they had SARs.

Keywords: Elderly; Latent TB infection; Systemic adverse reactions; Treatment interruption.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Incidence
  • Isoniazid / adverse effects
  • Isoniazid / therapeutic use
  • Kidney Failure, Chronic / drug therapy
  • Latent Tuberculosis / diagnosis*
  • Latent Tuberculosis / drug therapy
  • Latent Tuberculosis / epidemiology
  • Latent Tuberculosis / microbiology
  • Male
  • Middle Aged
  • Prospective Studies
  • Rifampin / adverse effects
  • Rifampin / analogs & derivatives
  • Rifampin / therapeutic use
  • Taiwan / epidemiology

Substances

  • Antitubercular Agents
  • Isoniazid
  • Rifampin
  • rifapentine