Rifapentine + isoniazid for latent tuberculosis infection in Brazil: a retrospective cohort study

<bold>Introduction:</bold> Treatment of Latent Tuberculosis Infection (LTBI) is a public health challenge due to its duration and adverse events (AE) that lead to therapy cessation. In 2021, Brazil recommended isoniazid (H) + rifapentine (P) to treat LTBI aiming to reduce AE and increase adherence. <bold>Objectives:</bold> Our goal was to describe patients treated for LTBI in a university hospital and compare outcomes according to the regimen. <bold>Methods:</bold> In this single-center study, secondary data were extracted from database of the tuberculosis special treatment information system. A total of 279 patients were notified for LTBI at Pedro Ernesto University Hospital in Rio de Janeiro, Brazil from 2018 to 2023. Statistical analysis used the Chi-square test with p < 0.05 considered statistically significant. <bold>Results:</bold> Out of 279 patients, 65.2% were female, with a mean age of 48 years (SD±15). The main indications for LTBI treatment were: use of immunobiological and/or immunosuppressant (83.5%) and HIV infection (5.2%). The prescribed regimens were as follows: H for 73.5% of patients, HP for 17.9%, and Rifampicin (R) for 8.6%. The 247 known outcomes were compared based on the regimens used. Among patients who used H, 20% were lost to follow-up vs. 4.8% R vs. 3.2% HP. In addition, the therapy that resulted in the lowest suspension rate was HP (3.2% vs. 5.6% H vs. 14.3% R). <bold>Conclusion:</bold> Group that used HP had a higher rate of therapy completion (93.5% vs. 81% in the R group vs. 74.4% in the H group) with p = 0.03. In this sample, patients receiving the H regimen had higher frequencies of adverse events leading to treatment suspension, while the use of HP was better tolerated and had higher rates of treatment completion.