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Isoniazid preventive therapy in HIV-infected and -uninfected children (0 - 14 years)

Hendrik S Schaaf, Mark F Cotton, Gerald P G Boon, Prakash M Jeena

Abstract


Isoniazid preventive therapy (IPT) prevents tuberculosis (TB) in immunocompetent children <5 years of age after exposure to an infectious TB source case. Routine IPT has been advocated in all HIV-infected children without TB, but has been controversial. Antiretroviral therapy markedly reduces the risk for TB in HIV-infected children, especially when started early in infancy. In HIV-infected children, as in HIV- uninfected children, we recommend post-exposure IPT after each TB exposure episode; but in HIV-infected children, this should be given irrespective of age or antiretroviral therapy. However, evidence for routine IPT without known exposure to TB in HIV-infected children is not convincing and is therefore not recommended. 


Authors' affiliations

Hendrik S Schaaf, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa

Mark F Cotton, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa

Gerald P G Boon, Department of Paediatrics and Child Health, Faculty of Health Sciences, Walter Sisulu University, East London, South Africa

Prakash M Jeena, Department of Paediatrics and Child Health, Nelson R Mandela School Of Medicine, University of KwaZulu-Natal, Durban, South Africa

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Keywords

isoniazid preventive therapy; IPT; children; HIV; tuberculosis

Cite this article

South African Medical Journal 2013;103(10):714-715. DOI:10.7196/SAMJ.7189

Article History

Date submitted: 2013-06-22
Date published: 2013-09-04

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