Comparing Treatment Completion Of Daily Rifapentine & Isoniazid For One Month (1HP) To Weekly High Dose Rifapentine & Isoniazid For 3 Months (3HP) In Persons Living With HIV and in Household Contacts of Recently Diagnosed Tuberculosis Patients
Daily rifapentine and isoniazid for 4 weeksWeekly rifapentine and isoniazid for 12 weeks
Daily rifapentine and isoniazid for 4 weeks: Arm A: isoniazid (300mg) and rifapentine (600mg) daily for 4 weeks (1HP)
Weekly rifapentine and isoniazid for 12 weeks: Arm B: isoniazid (900mg) and rifapentine (900mg) weekly for 12 weeks (3HP)
Study summary
A multicenter, randomized, stratified, open-label, phase IV trial among HIV-positive persons (PLHIV) on antiretroviral therapy (ART), or HIV-negative household contacts of patients with rifampicin-sensitive pulmonary tuberculosis (TB), who do not have evidence of active TB.
Eligibility
Sex
ALL
Min age
13 Years
Max age
—
Healthy volunteers
No
Group 1: HIV-positive adolescents and adults in South Africa and India
Inclusion criteria:
1. Age ≥ 13 years
2. Weight \> 30 kg
3. HIV-seropositive
4. HIV viral load \<400 copies/mL, defined as "virally suppressed," on an EFV or DTG-based ART regimen (see Section 3.6.2)
5. Candidates must meet WHO criteria for receiving TPT
Exclusion criteria:
1. Confirmed or suspected TB disease (evidenced by symptoms and/or clinical exam findings and/or chest radiographic findings suggestive of TB, positive mycobacterial culture or molecular TB testing or currently on TB treatment for active TB disease)
2. Likely to move from the study area during the study period
3. Known recent exposure to a TB case with resistance to isoniazid or rifampicin.
4. Previous treatment for active or latent TB for more than 30 days within the past 2 years
5. On nevirapine, etravirine, rilpivirine, PI-based, or raltegravir-containing ART regimens
6. Known sensitivity or intolerance to isoniazid or rifamycins
7. Suspected acute hepatitis or known chronic or unstable liver disease\^
8. ALT \> 3 times the upper limit of normal (ULN)
9. Total bilirubin \> 2.5 times the ULN
10. Pregnancy or breastfeeding Females of childbearing potential who are unable or unwilling to use two forms of contraception\*\*
11. On prohibited medications (see Appendix I)
Group 2: HIV-negative household contacts of an adult with confirmed pulmonary TB in Mozambique and Indonesia
Inclusion criteria:
1. Age ≥ 13 years
2. Weight \> 30 kg
3. HIV-negative
4. Household contact of an adult with confirmed rifampicin-sensitive pulmonary TB
5. Candidates must meet WHO criteria for receiving TPT
Exclusion criteria:
1. Confirmed or suspected TB disease (evidenced by symptoms and/or clinical exam findings and/or chest radiographic findings suggestive of TB, positive mycobacterial culture or molecular TB testing or currently on TB treatment for active TB disease)
2. Likely to move from the study area during the study period
3. Known exposure to TB cases with resistance to isoniazid or rifampicin in the source case
4. Previous treatment for active or latent TB for \>30 days within the past 2 years
5. Known sensitivity or intolerance to isoniazid or rifamycins
6. Suspected acute hepatitis or known chronic or unstable liver disease\^
7. ALT \> 3 times the upper limit of normal (ULN)
8. Total bilirubin \> 2.5 times the ULN
9. Pregnancy or breastfeeding Females of childbearing potential who are unable or unwilling to use two forms of contraception\*\*
10. On prohibited medications
Primary outcome measure(s)
Treatment adherence- self-report — from study entry at Week 0 through up to 8 weeks of 1HP (Group 1) or up to 24 weeks of 3HP (Group 2) , to be reported at end of trial Completion of TPT with \>90% adherence documented by self-report (both groups, Arms A and B)
Treatment adherence- pill count — from study entry at Week 0 through up to 8 weeks of 1HP (Group 1) or up to 24 weeks of 3HP (Group 2) , to be reported at end of trial Completion of TPT with \>90% adherence documented by pill count (both groups, Arms A and B)
Treatment adherence- electronic monitoring device (EMD) — from study entry at Week 0 through up to 8 weeks of 1HP (Group 1) or up to 24 weeks of 3HP (Group 2) , to be reported at end of trial Completion of TPT with \>90% adherence documented by pill count (both groups, Arms A and B)
Adverse Events — from study entry at Day 0 through Month 6 (Week 24), to be reported at end of trial Occurrence of Grade 2 or higher targeted safety events (both groups, Arms A and B). Targeted safety events are hypersensitivity syndrome, rash, seizure, peripheral neuropathy, hepatotoxicity, nausea and vomiting, and drug-related fever.
Early treatment discontinuation — from study entry at Week 0 through up to 8 weeks of 1HP (Group 1) or up to 24 weeks of 3HP (Group 2), to be reported at end of trial discontinuation of study medications because of side effects (both groups, Arms A and B)
Trial sites (4)
Facility
City
Region
Status
The Byramjee Jeejeebhoy Medical Centre (BJGMC-JHU) CRS
Pune
Maharashtra
Yayasan KNCV - The Persahabatan Hospital, Jakarta
Jakarta
Jaya
Fundação Aurum (The Aurum Institute Mozambique)
Chokwé
Gaza Province
The Aurum Institute: Gavin J Churchyard Legacy Centre
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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