Isoniazid prophylaxis based on tuberculosis risk factors in living kidney transplantation recipients: A retrospective cohort study.

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  • Additional Information
    • Source:
      Publisher: Elsevier Science Publishers Country of Publication: Netherlands NLM ID: 9111860 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7913 (Electronic) Linking ISSN: 09248579 NLM ISO Abbreviation: Int J Antimicrob Agents Subsets: MEDLINE
    • Publication Information:
      Original Publication: Amsterdam : Elsevier Science Publishers, c1991-
    • Subject Terms:
      Isoniazid*/therapeutic use ; Kidney Transplantation*/adverse effects ; Antitubercular Agents*/therapeutic use ; Antitubercular Agents*/adverse effects ; Tuberculosis*/prevention & control ; Tuberculosis*/epidemiology ; Transplant Recipients*; Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Risk Factors ; Adult ; Incidence ; Living Donors
    • Abstract:
      Background: Tuberculosis (TB) is a major and severe opportunistic infection among solid organ transplant recipients. Chemoprophylaxis is advised for those with latent tuberculosis infection. However, the effectiveness of an isoniazid (INH) prophylactic approach based on TB risk factors remains uncertain.
      Methods: This study included all living-donor kidney transplant recipients between January 2016 and December 2022. The recipients were categorized into three groups: the risk group with INH (R-INH), the risk group without INH (R-NINH), and the non-risk group (NR), based on the presence of TB risk factors and INH usage. The R-INH group received a 6-month INH prophylactic regimen to prevent post-transplant TB infection. The incidence of active TB among the groups was assessed.
      Results: A total of 1348 patients were divided into R-INH (n = 108), R-NINH (n = 371), and NR (n = 869). Forty-seven patients (3.49%) developed TB with an incidence rate of 16.0 per 1000 person-years. Compared to NR, the TB incidence in R-INH was not statistically different (hazard ratios, 0.55, 95% confidence interval, 0.07-4.21, P = 0.564), whereas it was significantly higher in R-NINH (hazard ratios, 5.04, 95% confidence interval, 2.64-9.62, P < 0.001). The median time from transplantation to TB was 19 months (interquartile range: 6-39), and 18 patients (38.3%) were diagnosed within 1 year of transplantation. Ninety-four patients (87.0%) completed INH prophylaxis, with adverse events including two cases of hepatotoxicity (1.85%) and one case of peripheral neuritis (0.93%).
      Conclusions: A 6-month INH regimen based on TB risk factors is effective and well-tolerated for preventing post-transplant TB in kidney transplant recipients.
      (Copyright © 2024 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.)
    • Contributed Indexing:
      Keywords: Isoniazid; Kidney transplantation; Prophylaxis; Tuberculosis
    • Accession Number:
      V83O1VOZ8L (Isoniazid)
      0 (Antitubercular Agents)
    • Publication Date:
      Date Created: 20241101 Date Completed: 20241213 Latest Revision: 20241213
    • Publication Date:
      20241214
    • Accession Number:
      10.1016/j.ijantimicag.2024.107375
    • Accession Number:
      39486467