Implementing TB preventive therapy: lessons from a large-scale initiative in India

<sec><title>BACKGROUND</title>TB infection management is essential in addressing the global TB burden. TB programmes worldwide are focusing on WHO-recommended shorter duration TB preventive treatment (TPT). We document early findings of 3HP regimen (rifapentine-isoniazid weekly doses for 3 months) implementation under the Joint Effort for Elimination of Tuberculosis (JEET) project in India.</sec><sec><title>METHODS</title>This is a descriptive cohort study involving household contacts (HHCs) of pulmonary TB patients on TPT in select districts of the JEET project supported by FIND. The HHCs received 3HP in two districts while those in other districts received 6-month daily isoniazid (6H) during April-September 2022. The study compared characteristics, adverse events (AEs) and TPT outcomes of HHCs on 3HP with those on 6H.</sec><sec><title>RESULTS</title>A total of 635 HHCs were initiated on 3HP, while 24,350 HHCs received 6H. About 10% of HHCs on 3HP developed AEs compared with 4% HHCs on 6H. However, a higher proportion of HHCs on 3HP completed TPT compared with HHCs on 6H (95% vs. 84%, <i>P</i> < 0.001).</sec><sec><title>CONCLUSION</title>High TPT completion rates for 3HP with low levels of manageable AEs support expansion of 3HP under national TB programmes. The 3HP TPT regimen could be considered an effective shorter TPT option in high-TB-burden countries.</sec>.