CROI PRESS CONFERENCE - RANDOMIZED TRIAL OF SAFETY OF ISONIAZID PREVENTIVE THERAPY DURING OR AFTER PREGNANCY

Where: Room 210
When: Wednesday, March 7, 12:15 – 1: 15 p.m.

Amita Gupta, M.D., deputy director of the Johns Hopkins University Center for Clinical Global Health Education at the Johns Hopkins University School of Medicine, will present a multicounty study of preventive treatment for tuberculosis (TB) in HIV-infected pregnant and postpartum women—a group at high risk of contracting and spreading TB. To our knowledge, this is the first large trial to focus on TB prevention in pregnant and postpartum women.

Current WHO and CDC guidelines suggest isoniazid preventive therapy is safe to use in pregnancy and is recommended for HIV-infected pregnant women living in both low and high TB burden settings. These guidelines are backed by low-quality evidence because pregnant women have been uniformly excluded from participating in the numerous TB prevention trials that have been conducted to date. Gupta and her team set out to demonstrate the safety of treating during pregnancy versus waiting until the postpartum period. To their surprise, researchers found that treatment in either setting was associated with high rates of serious toxicity. The researchers recommend that global guidelines be reassessed and that pregnant women be included in trials of TB prevention and treatment so clear evidence can be generated to inform this important population.

Dr. Gupta will also present her research at 11:45 a.m. on Wednesday, March 7, in Ballroom C.

SAFETY AND EFFICACY OF DOLUTEGRAVIR-BASED ART IN TB/HIV CO-INFECTED ADULTS AT WEEK 24

Presented during Oral Abstract 0-03 Advances in TB and Cryptococcal Meningitis Treatment and Prevention

Where: Ballroom C
When: Monday, March 5, 10:30 a.m.

Kelly Dooley, M.D., M.P.H., Ph.D., associate professor of medicine at the Johns Hopkins University School of Medicine, will present a study showing that people with HIV and TB can be safely treated with the latest global HIV cocktail using the drug dolutegravir. Drug-drug interactions between TB and HIV treatments present a roadblock to treatment. Dolutegravir is the preferred treatment supported by the WHO, but it has serious interactions with TB therapy that could render it inactive. Dooley has demonstrated a way to safely co-administer the treatments.

ONE MONTH OF RIFAPENTINE/ISONIAZID TO PREVENT TB IN PEOPLE WITH HIV: BRIEF-TB/A5279

Presented during Oral Abstract 0-03 Advances in TB and Cryptococcal Meningitis Treatment and Prevention

Where: Ballroom C
When: Monday, March 5, 11:30 a.m.

Richard Chaisson, M.D., director of the Center for Tuberculosis Research, Amita Gupta, M.D., deputy director of the Johns Hopkins University Center for Clinical Global Health Education, and Eric Nuermberger, M.D., professor of medicine, all at the Johns Hopkins University School of Medicine, present a revolutionary regimen that treats latent tuberculosis (TB) infection in just one month, rather than the three-, six- or nine-month treatments commonly used. The researchers anticipate that this will make preventive treatment of TB much more accessible to those in need of treatment and will benefit global TB control.

A CLUSTER-RANDOMIZED TRIAL OF SYMPTOM VS TST SCREENING TO IMPROVE CHILD IPT UPTAKE

Presented during Oral Abstract 0-03 Advances in TB and Cryptococcal Meningitis Treatment and Prevention

Where: Ballroom C
When: Wednesday, March 7, 10:15 a.m.

Nicole Salazar-Austin, M.D., instructor of pediatrics at the Johns Hopkins University School of Medicine, will present a simpler way of ensuring that young children in South Africa who were exposed to tuberculosis (TB) in households—a very high-risk group—get treated to prevent TB. Screening with symptoms alone was recommended by the WHO in 2006 to simplify screening. This recommended process removes additional visits required for tuberculin-skin testing and unnecessary referrals to pediatricians at district hospitals. While the new approach was not more effective, it was performed safely in a South African real-world setting. These results support symptom screening, but also highlight the importance of improving all steps required for children to initiate and complete TB preventive therapy. These results will have important implications for TB programs, global policies and the future of TB prevention in young children.